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Do the adverse physical effects of breast cancer surgery affect participation in physical activity and sport?

      Background: Women living with breast cancer are encouraged to participate in physical activity to maximise their disease prevention and health promotion. Little is known, however, of the extent that exercise participation is limited by the adverse physical effects following different types of breast cancer surgery. This study investigated how the adverse physical effects following different types of breast cancer surgery are perceived to limit physical activity and sport.
      Methods: 506 Australian women who had breast cancer surgery (breast conserving surgery (BCS) n=176, mastectomy (MAST) n=167, breast reconstruction surgery (BRS) n=163) completed an on-line survey where they retrospectively ranked the perceived frequency and severity of their adverse physical effects and their impact on physical activity and sport 6, 12-, and 24-months post-surgery. Fisher exact tests compared the frequency amongst the three groups with moderate-to-very-high frequency/severity scores (≧ 6/10) versus scores <6/10 for each adverse physical effect; (ii) moderate-to-very-high Total scores (≧36/60) versus total scores <36/60; and (iii) in “Agreement” that their physical activity and sport were limited (agree versus disagree) at the three points of time (3, 6, 12 months). The frequency of the entire cohort (n=632) with Total scores ≧36/60 were grouped according to previously identified risk factors (yes/no) and independent t-tests compared the mean Total scores grouped according to these identified risk factors (p < 0.05).
      Results: At 6 months following surgery, 43-58% of respondents perceived physical activity/sport were limited by their adverse physical effects, which were moderate-to-very-high in frequency/severity and over multiple body regions for ~ 25% of respondents. Sport was perceived to be limited by a significantly higher percentage of the BRS group compared to the MAST and BCS groups at 6 months post-surgery (p<0.05). Physical activity and sport were limited by a significantly higher percentage of the BRS and MAST groups compared to the BCS group at 12 months post-surgery (p<0.05). A significantly higher percentage reported moderate-to-very-high adverse physical effects if they: (i) had lymph nodes removed (p=0.012); (ii) had post-operative complications (p<0.001); and (iii) were younger than 50-years (p=0.048).
      Discussion: Physical activity and the resumption of sport is limited for a high percentage of women following all types of breast cancer, particularly following breast reconstruction surgery because of adverse physical effects of surgery/treatment. Greater investment in physical rehabilitation following all types of breast cancer surgery is required to enable women to participate in physical activity and resume sport.
      Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest relevant to the submission of this abstract.