Treatment related morbity in breast cancer patients : a comparative study

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This thesis describes treatment related upper limb morbidity, perceived disabilities in activities of daily life and quality of life in breast cancer patients. Breast cancer treatment is from its early beginning associated with upper limb morbidity including pain and numbness, reduced range of motion of the shoulder, muscle weakness of the arm and hand and lymph edema. Primarily the surgical treatment of the axilla (axillary lymph node dissection [ALND]). gives rise to long-term problems with shoulder movement and lymph edema of the arm. Additional radiation therapy of the axilla may increase upper limb morbidy due to late normal tissue radiation injury. In the early nineties sentinel lymph node biopsy (SLNB) was introduced for staging of the axilla and nowadays SLNB is an excellent alternative for ALND in patients with clinically negative lymph nodes. Research that has been performed to evaluate SLNB related morbidity in comparison to ALND related morbidy, reported less morbidity for SLNB in comparison to ALND. A general methodological shortcoming in these studies is the absence of pre-treatment assessment and the absent of reliable and valid assessment instruments. Also relationship between treatment modalities and treatment related upper limb morbidity and Activities of Daily Life (ADL) and Quality of Life (QOL) was scarcely subject of study in the past. Zie: Summary

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