Prevalence of breast cancer treatment sequelae over 6 years of follow-up: The pulling through study

BACKGROUND: There is a need to better describe and understand the prevalence of breast cancer treatment-related adverse effects amenable to physical therapy and rehabilitative exercise. Prior studies have been limited to single issues and lacked long-term follow-up. The Pulling Through Study provides data on prevalence of adverse effects in breast cancer survivors followed over 6 years. METHODS: A population-based sample of Australian women (n = 287) diagnosed with invasive, unilateral breast cancer was followed for a median of 6.6 years and prospectively assessed for treatment-related complications at 6, 12, and 18 months and 6 years after diagnosis. Assessments included postsurgical complications, skin or tissue reaction to radiation therapy, upper-body symptoms, lymphedema, 10% weight gain, fatigue, and upper-quadrant function. The proportion of women with positive indication for each complication and 1 or more complication was estimated using all available data at each time point. Women were only considered to have a specific complication if they reported the highest 2 levels of the Likert scale for self-reported issues. RESULTS: At 6 years after diagnosis, more than 60% of women experienced 1 or more side effects amenable to rehabilitative intervention. The proportion of women experiencing 3 or more side effects decreased throughout follow-up, whereas the proportion experiencing no side effects remained stable around 40% from 12 months to 6 years. Weight gain was the only complication to increase in prevalence over time. CONCLUSIONS: These data support the development of a multidisciplinary prospective surveillance approach for the purposes of managing and treating adverse effects in breast cancer survivors.