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Aims: Although arm/shoulder morbidity after sentinel lymph node biopsy (SLNB) and/or axillary lymph node dissection (ALND) has been studied before, information is lacking concerning self-imposed restrictions in activities and long-term consequences of both surgical procedures in relationship to quality of life (QoL) and anxiety., Methods: Eighty-nine disease-free breast cancer survivors completed a set of questionnaires assessing arm/shoulder symptoms, limitations in daily life, anxiety and QoL. Also, the ipsi- and contra lateral arm circumference and the range of shoulder motion were measured., Results: Fifty-one women had SLNB, 25 had SLNB followed by ALND and 13 had ALND. Although ALND patients experienced more shoulder symptoms, limitations in daily life and imposed more restrictions on themselves than SLNB patients, no significant differences during physical examination were found. A decreased range of motion and a higher score on trait anxiety resulted in a lower QoL. Trait anxiety and perceived limitations in daily life predicted long-term quality of life., Conclusions: There is a discrepancy between experienced and measured limitations in range of shoulder motion. Anxiety and self-imposed restrictions play an important role in predicting long-term QoL and should get the necessary attention when addressing shoulder symptoms in breast cancer patients., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Quality of life (QoL) in breast cancer survivors has become increasingly important. However, QoL is often assessed using a questionnaire meant to assess health status (HS). In this study the differences in outcomes between a HS and QoL questionnaire are shown and the correlation between both questionnaires is assessed., Methods: From the 140 breast cancer survivors that participated in the study, 68 received breast conserving therapy (BCT) and 72 were treated with mastectomy (MTC). HS was measured using the RAND-36 and QoL was assessed with the WHOQOL-100. Scores were compared with healthy reference populations., Results: The scores on QoL in both treatment groups were comparable to those of healthy women. HS scores showed lower physical functioning and general health perceptions for the MTC women. Pearson correlations between both questionnaires ranged between 0.19 and 0.75. Thus, the results of both questionnaires were not interchangeable., Conclusion: A HS questionnaire reflects functional impairments and reveals different areas of concern compared with a QoL questionnaire. The latter reflects the (dis)satisfaction of a patient and this seems not to mirror the functional limitations. Assessment of both objective functioning and subjective appraisal of functioning will result in treatment suggestions that meet the patients needs.

Quality of life is of increasing importance in clinical oncology studies. When analysing publications concerning quality of life in breast cancer, however, the majority of the articles appear to study health status and not quality of life. Therefore five recommendations were formulated to apply reading a 'quality of life' article. With the use of these recommendations an article can be evaluated and the clinical significance can be assessed.