Influence of Shoulder Joint Function and Postoperative Subjective Symptoms on Health Related QOL of Breast Cancer Patients

Purpose: The purpose of this study was to investigate the psychological effects on health-related quality of life (HRQOL) of postoperative range of motion of the shoulder joint and subjective symptoms in patients with breast cancer who underwent rehabilitation. Methods: In 79 patients with breast cancer surgery who underwent rehabilitation during hospitalization, we investigated temporal changes in the range of shoulder joint function (flexion of shoulder joint/abduction angle), postoperative subjective symptoms (surgical site pain, tightness, and anxiety regarding the disorder), and HRQOL scales (FACT-B and EQ-5D-5L) from before to 6 months after surgery and examined the factors relating to HRQOL. Results: The range of shoulder joint movement was significantly decreased even from pre-operation to 1 month after surgery, but subjective symptoms had significantly improved at 6 months after surgery. Multivariable regression analysis showed that postoperative feelings of anxiety felt at 1, 3, and 6 months after surgery were a significant variable influencing the FACT-B and EQ-5D-5L scales. The path coefficients of the standard partial regression coefficients of breast cancer patients at 6 months postoperatively by covariance structure analysis were 0.66 for the EQ-5D-5L effective value, 0.94 for FACT-B, 0.47 for shoulder joint function, and −0.64 for postoperative subjective symptoms as the latent variables of HRQOL. Conclusion: The results suggested the importance of interventions that focus on postoperative subjective symptoms to possibly improve not only patient function but also postoperative HRQOL.