Identifying prognostic variables for persistent upper limb dysfunctions after breast cancer treatment: Protocol of a longitudinal cohort study.

Introduction: Breast cancer is the most frequently occurring cancer with increasing surviving rates thanks to improving accuracy of detecting methods, early diagnosis and advances in cancer treatment. However, many breast cancer survivors (BCS) suffer of persistent upper limb (UL) dysfunctions. Therefore, the aim of this study is to identify the contributing factors to persistent UL dysfunctions in terms of identifying targets for prospective evaluation and specific treatment approaches at specific time points during breast cancer treatment. Methods: A cohort study will be performed in 250 BCS with a unilateral primary cancer, assessing different aspects of the International Classification of Function, Disease and Health (ICF). The BCS will be assessed at 5 different timepoints (baseline, 1 month post-surgery, 1 month post-chemotherapy, 1 and 6 months post-radiotherapy). Results: Candidate contributors to persistent UL dysfunctions are: specific pain characteristics, soft tissue stiffness, lymph node and lymph vessels functions, breast cancer treatment modalities, personal factors such as, pain catastrophizing, self-efficacy, depression, anxiety, stress and fear of movement, access to healthcare and movement alterations of the upper limb. Discussion: A prediction model for persistent UL dysfunctions will be formed covering all aspects of the ICF. Process evaluation: The study is now prepared for ethical committee, with appreciated assistance of a clinical trial assistant who guide us through the complex process. [ABSTRACT FROM AUTHOR]