Do Patient-Reported Upper-Body Symptoms Predict Breast Cancer-Related Lymphoedema: Results from a Population-Based, Longitudinal Breast Cancer Cohort Study

SIMPLE SUMMARY: Using data from 2442 women with invasive breast cancer, we explored the relationship between upper-body symptoms and upper-body function, breast cancer-related lymphoedema (BCRL), physical activity levels, and quality of life, and assessed whether the presence of upper-body symptoms predicts BCRL. We measured women at three time-points: baseline (between 2- and 9-months post-diagnosis), and at 2- and 7-years post-diagnosis. Upper-body symptoms are common post-breast cancer, and persist into longer-term survivorship. The presence of symptoms is associated with poorer upper-body function, and lower physical activity levels and quality of life. The presence of one or more symptoms of moderate severity or higher at baseline is associated with increased odds of developing BCRL by 2- and 7-years post-diagnosis, with the higher number of symptoms associated with higher odds. ABSTRACT: The objectives of this work were to (i) describe upper-body symptoms post-breast cancer; (ii) explore the relationship between symptoms and upper-body function, breast cancer-related lymphoedema (BCRL), physical activity levels, and quality of life; and (iii) determine whether the presence of upper-body symptoms predicts BCRL. Nine symptoms, upper-body function, lymphoedema, physical activity, and quality of life were assessed in women with invasive breast cancer at baseline (2- to 9-months post-diagnosis; n = 2442), and at 2- and 7-years post-diagnosis. Mann–Whitney tests, unpaired t-tests, and chi-squared analyses were used to assess cross-sectional relationships, while regression analyses were used to assess the predictive relationships between symptoms at baseline, and BCRL at 2- and 7-years post-diagnosis. Symptoms are common post-breast cancer and persist at 2- and 7-years post-diagnosis. Approximately two in three women, and one in three women, reported >2 symptoms of at least mild severity, and of at least moderate severity, respectively. The presence of symptoms is associated with poorer upper-body function, and lower physical activity levels and quality of life. One or more symptoms of at least moderate severity increases the odds of developing BCRL by 2- and 7-years post-diagnosis (p < 0.05). Consequently, improved monitoring and management of symptoms following breast cancer have the potential to improve health outcomes.