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Purpose: Pain and sensory disturbances are common side effects of breast cancer treatment. Differential somatosensory functioning may reflect distinct pathophysiological backgrounds and therapeutic needs. Aim was to examine whether questionnaires evaluating signs and symptoms related to somatosensory functioning correlate sufficiently with quantitative sensory testing (QST) in breast cancer survivors to warrant consideration for somatosensory profiling in clinical practice., Methods: One year after breast cancer surgery, 147 women underwent QST and completed following questionnaires: Douleur Neuropathique en 4 questions (DN4), Central Sensitization Inventory, Margolis Pain Diagram and Visual Analog Scales (VAS). Associations between the questionnaires and QST were evaluated using Spearman correlation coefficients (rs)., Results: Significant but weak ( r s < 0.30) correlations were found between total DN4 score and QST results at the inner upper arm for detection of sharp stimuli ( r s = 0.227), cold stimuli ( r s = -0.186), and painful heat stimuli ( r s = 0.179), as well as between QST evaluating conditioned pain modulation and the Margolis Pain Diagram on one hand ( r s = 0.176) and minimum-maximum pain intensity differences (VAS) on the other ( r s = -0.170)., Conclusion: Questionnaires evaluating signs and symptoms related to somatosensory functioning are insufficient for somatosensory profiling. Although somatosensory profiling may be valuable in a mechanism-based management, more research on the most appropriate clinical tools is needed.IMPLICATIONS FOR REHABILITATIONClinicians should be able to recognize that patients with persistent pain or sensory disturbances following breast cancer surgery may have a component of altered somatosensory processing as a significant contributor to their complaint in order to address it appropriately.Somatosensory profiling has yet to be implemented into clinical practice.No evidence-based recommendations can be made on the use of self-reported questionnaires to assess somatosensory processing in a breast cancer population based on the findings of this study.It is suggested to combine information on how individuals process and experience somatosensory stimulation with information from the patient interview or questionnaires to consider which biological, psychological and/or social factors may drive or sustain these neurophysiological processes.

Purpose: Upper limb (UL) function is one of the health outcomes that matters the most for women with breast cancer. However, a better understanding of the factors contributing to UL dysfunctions in the late stage after breast cancer surgery is needed. This study explores associations between impairment-related and cognition-related factors and UL function in women with pain and myofascial dysfunctions at the affected UL region in this late stage after breast cancer surgery., Methods: In forty-one women, UL function (dependent variable) was evaluated by the Disabilities of Arm, Shoulder and Hand questionnaire. As independent impairment-related factors, relative excessive arm volume (perimetry), pain intensity (maximum score on the visual analogue scale past week) and humerothoracic elevation and scapular lateral rotation (kinematic analysis) were assessed. As independent cognition-related factors, pain catastrophizing (Pain Catastrophizing Scale) and pain hypervigilance (Pain Vigilance and Awareness Questionnaire) were evaluated. Bi-variable analyses and a stepwise regression analysis were used to explore associations., Results: A higher pain intensity ( r  = 0.52; p  < 0.001), more pain catastrophizing ( r  = 0.49; p  < 0.001) and more pain hypervigilance ( r  = 0.40; p  = 0.01) were related to more UL dysfunction. Pain intensity ( p  = 0.029) and pain catastrophizing ( p  = 0.027) explained furthermore 29.9% of variance in UL function., Conclusions: Pain intensity and cognition-related factors are significantly associated with UL function in women with pain and myofascial dysfunctions, indicating the need of assessing pain beliefs in women in the late stage after breast cancer surgery.IMPLICATIONS FOR REHABILITATIONPain intensity and pain-related beliefs, including pain attention and catastrophizing, are related to the severity of upper limb dysfunctions in the late stage after breast cancer surgery.Impairments such as lymphedema and movement restrictions seem not related to upper limb function in the assessed sample.To understand upper limb dysfunctions in the late stage after breast cancer, assessing pain beliefs is needed.

Purpose: To investigate the variables per International Classification of Functioning, Disability and Health (ICF)-domain that are associated with upper limb (UL) function in women after breast cancer surgery., Materials and Methods: PubMed and Web of Science were searched until 7 January 2020. Eligibility criteria were: prospective investigation of an association between one or more variables of the ICF model and UL function in women after breast cancer surgery. PRISMA guidelines were used to conduct and report the systematic review. The Quality In Prognosis Studies tool (QUIPS) was used to evaluate risk of bias., Results: Twelve studies were included (2244 participants). Risk of bias of the included studies was low to moderate. Variables at the ICF-function level that were systematically associated with decreased UL function across multiple included papers were: increased UL pain, decreased shoulder range of motion, decreased handgrip strength and a higher number of comorbidities. Results on the association between UL function and variables at other ICF-domains were conflicting., Conclusion: UL function was associated with certain variables at the ICF-function level. Variability in disease stages, treatment and measurement methods might explain inconsistent associations with other variables. Only limited studies investigated associations between UL function and psychosocial factors.IMPLICATIONS FOR REHABILITATIONThis paper gives an overview of associations between different variables of the ICF model and UL dysfunctions in women after breast cancer surgery.Identified associated factors are situated at the ICF function level, i.e., UL pain, decreased handgrip strength and shoulder (abduction) ROM.These factors are modifiable and should be monitored, prevented and treated in physical therapy practice.UL dysfunction is not consistently associated with treatment-related variables.The role of psychosocial personal factors in UL dysfunctions should be considered and further explored.