Upper-Body Strength and Breast Cancer: A Comparison of the Effects of Age and Disease

BACKGROUND: In most studies of functional limitations in women with breast cancer, it is difficult to determine what difficulties are associated with breast cancer and what problems are likely to be found in women of the same age without the disease. In the present study, we report the age-specific prevalence of upper-body limitations in women with breast cancer over the course of one year, compared to that experienced by women of the same age without the disease. METHODS: Interviews were conducted with women with breast cancer ages 40-84 at 3 months (n = 934) and 12 months after diagnosis (n = 843). Controls were interviewed twice over the same period (n = 991 and 887, respectively). The main outcome was upper-body limitation, defined as the number of tasks requiring upper-body strength (0-4) reported by the respondent to be very difficult to complete or not done on doctor's orders. RESULTS: Cases ages 40-54, 55-64, and 65-74 were approximately twice as likely as age-matched controls to report upper-body limitations, adjusting for race, education, financial status, and comorbidity. There was no case/control difference among those ages 75-84. At one year, the breast cancer patients ages 40-54 and 55-64 showed the greatest improvement. CONCLUSIONS: Many women who survive breast cancer report significant limitations in upper-body strength in the first few months, followed, especially among younger women, by a period of recuperation. Rehabilitation and home-care programs should be designed to meet the special and more persistent needs of older women. New strategies for assessing upper-body strength are also suggested.