Assessment of Upper Limbs Functionality, Quality of Life and Postoperative Fatigue in Women with Breast Cancer at a Reference Hospital in the Amazon Region

Authors

  • Myara Cristiny Monteiro Cardoso Universidade Federal do Pará (UFPA), Hospital Universitário João de Barros Barreto (HUJBB), Laboratório de Avaliação e Reabilitação das Disfunções Cardiovascular, Oncológica e Respiratória (LACOR), Programa de Residência de Fisioterapia em Oncologia. Belém (PA), Brasil. https://orcid.org/0000-0002-2456-8034
  • Rayssa da Silva Araújo Universidade Federal do Pará (UFPA), Hospital Universitário João de Barros Barreto (HUJBB), Laboratório de Avaliação e Reabilitação das Disfunções Cardiovascular, Oncológica e Respiratória (LACOR), Programa de Residência de Fisioterapia em Oncologia. Belém (PA), Brasil. https://orcid.org/0000-0003-3700-1288
  • Jaqueline Pinheiro da Silva Universidade Federal do Pará (UFPA), Hospital Universitário João de Barros Barreto (HUJBB), Laboratório de Avaliação e Reabilitação das Disfunções Cardiovascular, Oncológica e Respiratória (LACOR), Programa de Residência de Fisioterapia em Oncologia. Belém (PA), Brasil. https://orcid.org/0000-0001-9110-7724
  • Rayane de Nazaré Monteiro Brandão Universidade Federal do Pará (UFPA), Hospital Universitário João de Barros Barreto (HUJBB), Laboratório de Avaliação e Reabilitação das Disfunções Cardiovascular, Oncológica e Respiratória (LACOR), Programa de Pós-graduação em Ciências do Movimento Humano (PPGCMH). Belém (PA), Brasil. https://orcid.org/0000-0001-5452-8167
  • Saul Rassy Carneiro Universidade Federal do Pará (UFPA), Hospital Universitário João de Barros Barreto (HUJBB), Laboratório de Avaliação e Reabilitação das Disfunções Cardiovascular, Oncológica e Respiratória (LACOR), Programa de Residência de Fisioterapia em Oncologia. Belém (PA), Brasil. https://orcid.org/0000-0002-6825-0239

DOI:

https://doi.org/10.32635/2176-9745.RBC.2025v71n4.5271

Keywords:

Upper Extremity, Muscle Strength, Quality of Life, Fatigue, Breast Neoplasms

Abstract

Introduction: Breast cancer has a significant impact on upper limbs (UL) functionality due to treatment and its complications. Objective: To assess UL functionality, quality of life and fatigue in women with breast cancer in the Amazon region. Method: Cross-sectional study with 42 participants. Data were collected from medical history and quality of life questionnaires Functional Assessment of Cancer Therapy-General (FACT-G) and Functional Assessment of Cancer Therapy-Breast plus Arm Morbidity (FACT B+4), fatigue, with Functional Assessment of Cancer Therapy-Fatigue (FACT-F), functionality, with Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and muscle strength, with isokinetic dynamometer. Spearman's correlation and Wilcoxon test were used. Results: 71.4% of the participants underwent conservative surgery. QuickDASH correlated with FACT-B+4 (r = -0.796), FACT-G (r = -0.781) and FACT-F (r = -0.815). FACT-F correlated with FACT-G (r = 0.949) and FACT-B+4 (r = 0.903). There was a significant difference in isokinetic strength between the operated and unoperated sides. Isokinetic strength correlated with pain and postoperative time, but not with clinical staging and QuickDASH. Conclusion: UL functionality is associated with fatigue and quality of life, but not with isokinetic strength. There was a significant difference between the operated and unoperated sides. Type of surgery, pain and postoperative time influenced isokinetic strength in women with breast cancer.

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References

Wilkinson L, Gathani T. Understanding breast cancer as a global health concern. Br J Radiol. 2022;95(1130):20211033. doi: https://doi.org/10.1259/bjr.20211033 DOI: https://doi.org/10.1259/bjr.20211033

Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: cancer today [Internet]. Lyon: International Agency for Research on Cancer; 2024 [acesso 2024 out 20]. Disponível em: https://gco.iarc.who.int/media/globocan/factsheets/populations/900-world-fact-sheet.pdf

Instituto Nacional de Câncer. Estimativa 2023: incidência de câncer no Brasil [Internet]. Rio de Janeiro: INCA; 2022. [Acesso 2025 abr 12]. Disponível em: https://www.inca.gov.br/publicacoes/livros/estimativa-2023-incidencia-de-cancer-no-brasil

Lovelace DL, McDaniel LR, Golden D. Long-term effects of breast cancer surgery, treatment, and survivor care. J Midwifery Womens Health. 2019;64(6):713-24. doi: https://doi.org/10.1111/jmwh.13012 DOI: https://doi.org/10.1111/jmwh.13012

Siqueira TC, Frágoas SP, Pelegrini A, et al. Factors associated with upper limb dysfunction in breast cancer survivors. Support Care Cancer. 2021;29(4):1933-40. doi: https://doi.org/10.1007/s00520-020-05668-7 DOI: https://doi.org/10.1007/s00520-020-05668-7

De Groef A, Van der Gucht E, Dams L, et al. The association between upper limb function and variables at the different domains of the international classification of functioning, disability and health in women after breast cancer surgery: a systematic review. Disabil Rehabil. 2022;44(8):1176-89. doi: https://doi.org/10.1080/09638288.2020.1800835 DOI: https://doi.org/10.1080/09638288.2020.1800835

Leonardis JM, Lulic-Kuryllo T, Lipps DB. The impact of local therapies for breast cancer on shoulder muscle health and function. Crit Rev Oncol Hematol. 2022;177:103759. doi: https://doi.org/10.1016/j.critrevonc.2022.103759 DOI: https://doi.org/10.1016/j.critrevonc.2022.103759

John DO, Amaeze A, Ransome OP, et al. Upper limb disabilities and associated factors among breast cancer survivors: a quantitative cross-sectional study. SAGE Open Med. 2024;12:20503121241283341. doi: https://doi.org/10.1177/20503121241283341 DOI: https://doi.org/10.1177/20503121241283341

Gómez MPA, Aparisi F, Battista G, et al. Functional and surgical anatomy of the upper limb: what the radiologist needs to know. Radiol Clin North Am. 2019;57(5):857-81. doi: https://doi.org/10.1016/j.rcl.2019.03.002 DOI: https://doi.org/10.1016/j.rcl.2019.03.002

Xie H, Ruan G, Deng L, et al. Comparison of absolute and relative handgrip strength to predict cancer prognosis: a prospective multicenter cohort study. Clin Nutr. 2022;41(8):1636-43. doi: https://doi.org/10.1016/j.clnu.2022.06.011 DOI: https://doi.org/10.1016/j.clnu.2022.06.011

Silva ACC, Bergmann A, Araujo CM, et al. Association of handgrip strength with quality of life in breast cancer survivors: a systematic review and meta-analysis. Asian Pac J Cancer Prev. 2022;23(10):3237-45. doi: https://doi.org/10.31557/apjcp.2022.23.10.3237 DOI: https://doi.org/10.31557/APJCP.2022.23.10.3237

Carpena-Niño MG, Altozano-Arroyo V, Cuesta-García C, et al. Impact of unilateral breast cancer surgery on upper limb functionality: strength, manual dexterity, and disability prediction. Healthcare (Basel) 2025;13(7):766. doi: https://doi.org/10.3390/healthcare13070766 DOI: https://doi.org/10.3390/healthcare13070766

Zeilinger EL, Zrnic-Novakovic I, Oppenauer C, et al Prevalence and biopsychosocial indicators of fatigue in cancer patients. Cancer Med. 2024;13(11):e7293. doi: https://doi.org/10.1002/cam4.7293 DOI: https://doi.org/10.1002/cam4.7293

Grusdat NP, Stäuber A, Tolkmitt M, et al. Routine cancer treatments and their impact on physical function, symptoms of cancer-related fatigue, anxiety, and depression. Support Care Cancer. 2022;30(5):3733-44. doi: https://doi.org/10.1007/s00520-021-06787-5 DOI: https://doi.org/10.1007/s00520-021-06787-5

Roldán-Jiménez C, Martín-Martín J, Pajares B, et al. Factors associated with upper limb function in breast cancer survivors. PM R. 2023;15(2):151-6. doi: https://doi.org/10.1002/pmrj.12731 DOI: https://doi.org/10.1002/pmrj.12731

Michels FAS, Latorre MRDO, Maciel MS. Validação e reprodutibilidade do questionário FACT-B+4 de qualidade de vida específico para câncer de mama e comparação dos questionários IBCSG, EORTC-BR23 e FACT-B+4. Cad Saúde Colet. 2012;20(3):321-8.

Oliveira IS, Costa LCM, Manzoni ACT, et al. Assessment of the measurement properties of quality of life questionnaires in Brazilian women with breast cancer. Braz J Phys Ther. 2014;18(4):372-83. doi: https://doi.org/10.1590/bjpt-rbf.2014.0045 DOI: https://doi.org/10.1590/bjpt-rbf.2014.0045

Cella DF, Tulsky DS, Gray G, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11(3):570-9. doi: https://doi.org/10.1200/jco.1993.11.3.570 DOI: https://doi.org/10.1200/JCO.1993.11.3.570

Ishikawa NM, Thuler LCS, Giglio AG, et al. Validation of the Portuguese version of Functional Assessment of Cancer Therapy-Fatigue (FACT-F) in Brazilian cancer patients. Support Care Cancer. 2010;18(4):481-90. doi: https://doi.org/10.1007/s00520-009-0697-0 DOI: https://doi.org/10.1007/s00520-009-0697-0

Yellen SB, Cella DF, Webster K, et al. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage. 1997;13(2):63-74. doi: https://doi.org/10.1016/s0885-3924(96)00274-6 DOI: https://doi.org/10.1016/S0885-3924(96)00274-6

Beaton DE, Wright JG, Katz JN, et al Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005;87(5):1038-46. doi: https://doi.org/10.2106/jbjs.d.02060 DOI: https://doi.org/10.2106/JBJS.D.02060

Silva NC, Chaves TC, Santos JB, et al. Reliability, validity and responsiveness of Brazilian version of QuickDASH. Musculoskelet Sci Pract. 2020;48:102163. doi: https://doi.org/10.1016/j.msksp.2020.102163 DOI: https://doi.org/10.1016/j.msksp.2020.102163

LeBlanc M, Stineman M, DeMichele A, et al. Validation of QuickDASH outcome measure in breast cancer survivors for upper extremity disability. Arch Phys Med Rehabil. 2014;95(3):493-8. doi: https://doi.org/10.1016/j.apmr.2013.09.016 DOI: https://doi.org/10.1016/j.apmr.2013.09.016

Drouin JM, Valovich-McLeod TC, Shultz SJ, et al. Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol. 2004 Jan;91(1):22-9. doi: https://doi.org/10.1007/s00421-003-0933-0 DOI: https://doi.org/10.1007/s00421-003-0933-0

Lee JH, Park JS, Jeong W-K. Importance of initial peak torque of the supraspinatus muscle during shoulder flexion. Clin Orthop Surg. 2022;14(2):272-80. doi: https://doi.org/10.4055/cios21133 DOI: https://doi.org/10.4055/cios21133

Nagata CA, Hamu TCDS, Neri SGR, et al. Associação entre medidas de força isocinética e desempenho funcional em pessoas idosas da comunidade. Fisioter Pesqui. 2023;30:e22014323pt. Disponível em: https://doi.org/10.1590/1809-2950/e22014323pt DOI: https://doi.org/10.1590/1809-2950/e22014323en

Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos [Internet]. Diário Oficial da União, Brasília, DF. 2013 jun 13. [acesso 2025 fev 14]; Seção 1:59. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html

Olson TL, Dames KD, Smith JD, et al. Relationships between physiological and self-reported assessment of cancer-related fatigue. Int J Exerc Sci. 2022;15(3):177-90. doi: https://doi.org/10.70252/sszo6869 DOI: https://doi.org/10.70252/SSZO6869

Macdonald ER, Amorim NML, Hagstrom AD, et al. Evaluating the effect of upper-body morbidity on quality of life following primary breast cancer treatment: a systematic review and meta-analysis. J Cancer Surviv. 2024;18(5):1517-47. doi: https://doi.org/10.1007/s11764-023-01395-0 DOI: https://doi.org/10.1007/s11764-023-01395-0

El Haidari R, Nerich V, Abou-Abbas L, et al. Pre-operative and early postoperative health-related quality of life of breast cancer woman: a lebanese prospective study. BMC Womens Health. 2023;23(1):187. doi: https://doi.org/10.1186/s12905-023-02348-6 DOI: https://doi.org/10.1186/s12905-023-02348-6

Malchrowicz-Mośko E, Nowaczyk P, Wasiewicz J, et al. The level of kinesiophobia in breast cancer women undergoing surgical treatment. Front Oncol. 2023;13:1010315. doi: https://doi.org/10.3389/fonc.2023.1010315 DOI: https://doi.org/10.3389/fonc.2023.1010315

Maciukiewicz JM, Hussein ATS, Mourtzakis M, et al. An evaluation of upper limb strength and range of motion of breast cancer survivors immediately following treatment. Clin Biomech (Bristol). 2022;96:105666. doi: https://doi.org/10.1016/j.clinbiomech.2022.105666 DOI: https://doi.org/10.1016/j.clinbiomech.2022.105666

Subasi S, Ozdemir Y, Basim P. Comparison of isokinetic parameters of the operated side versus non-operated side shoulder joint in breast cancer survivors. Gait Posture. 2023;106(Suppl 1):S197-8. doi: https://doi.org/10.1016/j.gaitpost.2023.07.239 DOI: https://doi.org/10.1016/j.gaitpost.2023.07.239

Klassen O, Schmidt ME, Ulrich CM, et al. Muscle strength in breast cancer patients receiving different treatment regimes. J Cachexia Sarcopenia Muscle. 2017;8(2):305-16. https://doi.org/10.1002/jcsm.12165 DOI: https://doi.org/10.1002/jcsm.12165

Perez CS, Neves LMS, Vacari AL, et al. Reduction in handgrip strength and electromyographic activity in women with breast câncer. J Back Musculoskelet Rehabil. 2018;31(1):447-52. doi: https://doi.org/10.3233/bmr-170848 DOI: https://doi.org/10.3233/BMR-170848

Min J, Yeon S, Ryu J, et al. Shoulder function and health outcomes in newly diagnosed breast cancer patients receiving surgery: a prospective study. Clin Breast Cancer. 2023;23(4):e247-58. doi: https://doi.org/10.1016/j.clbc.2023.03.001 DOI: https://doi.org/10.1016/j.clbc.2023.03.001

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Published

2025-08-15

How to Cite

1.
Cardoso MCM, Araújo R da S, Silva JP da, Brandão R de NM, Carneiro SR. Assessment of Upper Limbs Functionality, Quality of Life and Postoperative Fatigue in Women with Breast Cancer at a Reference Hospital in the Amazon Region. Rev. Bras. Cancerol. [Internet]. 2025 Aug. 15 [cited 2025 Dec. 5];71(4):e-055271. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/5271

Issue

Vol. 71 No. 4 (2025): oct./nov./dec.

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ORIGINAL ARTICLE

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