Table 7. Radiotherapy as a risk factor for arm morbidity following breast cancer treatments.
| Disability | Author | N | Follow-up | Measure | Comparison/Comments | P-value | OR/RR/HR | CI (95%) | Type of evidence | Evidence level |
|---|---|---|---|---|---|---|---|---|---|---|
| Persistent pain | Zararli 2009 [32] | 299 | VAS | 0.006 | RR = 2.80 | 1.341–3.821 | Prospective study | 2B | ||
| Habib 2020 [92] | 124 | 12 months | NPRS | 0.03 | OR = 2.52 | 1.13–5.82 | Prospective observational study | 2B | ||
| Hamood 2018 [24] | 410 | 7.4 years | NPRS | With or without chronic pain | 0.003 | OR = 2.96 | 1.43–6.12 | A cross-sectional study of a random sample | 4 | |
| Decreased range of motion | Ashikaga 2010 [37] | 3,963 | 36 months | 0.037 | OR = 2.48 | RCT | 1B | |||
| Adriaenssens 2012 [85] | 118 | 3 months | ROM | Abduction after radiation to regional nodes | 0.0011 | RCT | 1B | |||
| Zararli 2009 [32] | 299 | Physical examination | 0.006 | RR = 2.46 | 1.290–4.466 | Prospective study | 2B | |||
| Kuijer 2021 [17] | 1,037 | 1 year | CARES-SF | 0.01 | OR = 2.4 | Multicenter prospective cohort study | 2B | |||
| Kikuuchi 2020 [68] | 223 | 3 months | ROM | 0.006 | OR = 0.34 | 0.16–0.73 | Prospective study | 2B | ||
| Basu 2020 [60] | 342 | 37 months | Questionnaire was inspired by the Australian Breast Cancer Family Study | 0.01 | HR = 1.1 | 1.5–2.6 | Retrospective study | 4 | ||
| Ahmed 2011 [71] | 1,287 | Self-report | OR = 1.72 | 1.15–2.57 | Cross-sectional study | 4 | ||||
| Lymphedema | Ashikaga 2010 [37] | 3,963 | 36 months | Water displacement | 0.007 | OR = 3.47 | RCT | 1B | ||
| Zou 2018 [47] | 387 | 24 months | Circumference and Norman questionnaire | <0.001 | HR = 3.9 | 2.0–7.5 | Prospective study | 2B | ||
| Ozcinar 2012 [98] | 218 | 24–82 months | Circumference measurements | <0.001 | Prospective observational cohort | 2B | ||||
| Kilbreat 2016 [53] | 450 | 18 months | Circumferences and Bioimpedance spectroscopy | 0.01 | OR = 3.7 | 1.6–8.7 | Prospective cohort study | 2B | ||
| Ugur 2013 [62] | 455 | 53 months | Tape measure | 0.007 | OR = 1.83 | 1.17–2.84 | Prospective study | 2B | ||
| Bevilacqua 2012 [42] | 1,051 | 5 years | Circumferences | > 6 months | 0.0001 | Prospective cohort study | 2B | |||
| Park 2008 [63] | 450 | 24 months | Tape measure | Axillary radiotherapy | <0.001 | OR = 6.73 | 2.58–17.54 | Prospective study | 2B | |
| Kuijer 2021 [17] | 1,037 | 1-year | CARES-SF | 0.05 | OR = 1.8 | Multicenter prospective cohort study | 2B | |||
| Dominick 2013 [61] | 2,431 | 6 years | Norman and colleagues’ validated telephone lymphedema questionnaire | Lumpectomy and radiation | <0.01 | OR = 1.12 | 0.91–1.37 | Prospective cohort study | 2B | |
| Mastectomy and radiation | OR = 2.02 | 1.52–2.69 | ||||||||
| Ahmed 2011 [71] | 1,287 | Self-report | OR = 1.77 | 0.92–3.40 | Cross-sectional study | 4 | ||||
| Hack 2010 [59] | 316 | 12 months | Volume measurements | 0.007 | Cross-sectional study | 4 | ||||
| Herremans 2021 [43] | 132 | 5 years | Circumferences and bioimpedance spectroscopy | LYMPHA technique VS ALND | 0.032 | OR = 0.38 | 0.15–0.91 | Retrospective cross-sectional study | 4 | |
| Kwan 2002 [84] | 744 | Self-report | <0.001 | OR = 3.1 | Cross-sectional | 4 | ||||
| Sueangamiam 2021 [88] | 308 | Circumferences | 0.046 | HR = 1.81 | 1.09–13.28 | Cross-sectional study | 4 | |||
| Da Costa Vieira 2016 [3] | 622 | 10 years | Self-report | Supra-clavicular radiation | 0.043 | HR = 1.87 | 1.02–3.45 | Retrospective study | 4 | |
| Gärtner 2010 [36] | 3104 | Self-report | 0.0005 | OR = 1.72 | 1.30–2.27 | Repeated cross-sectional study | 4 | |||
| Crosby 2012 [58] | 1117 | From medical record | Immediate breast reconstruction and BMI <25/>25 | 0.023 | OR = 2.23 | 1.12–4.89 | Retrospective study | 4 |
Abbreviations: N: number; CI: confidence interval; OR: odds ratio; HR: hazard ratio; RR: relative risk; BMI: body mass index; ALND: axillary lymph node dissection; VAS: visual analog scale; ROM: range of motion; NPRS: numeric pain rating scale; RCT: randomize control trail.