PREDICTORS OF QUALITY OF LIFE WITH AXILLARY REVERSE
University of Kansas
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Breast cancer is the second most common cancer among women in the United States. Sentinel lymph node biopsy for staging early breast cancer in clinically node negative patients is supported by the American Society of Clinical Oncology due to a greater morbidity associated with axillary lymph node dissection. Quality of life benefits of sentinel lymph node biopsy compared to axillary lymph node dissection are inconsistent and many studies have used quality of life questionnaires alone. This descriptive correlational study was a primary analysis of factors that predicted quality of life over two years based on a modified Health Related Quality of Life Model. The sample consisted of 185 women, ages 29 to 88 who had the new axillary reverse mapping surgical procedure following an axillary lymph node dissection with sentinel lymph node biopsy or axillary lymph node dissection with or without sentinel lymph node biopsy. Descriptive analyses were conducted for occurrence of lymphedema and measures of physical function, general health perceptions, and health-related quality of life over two years. Individual characteristics, relationships of biological factors, symptoms, and functional status to general health perception and health-related quality of life were evaluated through separate regression analyses conducted at three time points over two years. Data were collected from the SF-36 and the axillary reverse mapping surgery form. Up to 31% of the variance in General Health Perception was explained by seven variables (age, body mass index, surgery, pain, lymphedema, physical functioning, and strength) with physical functioning and pain contributing the most. As much as 37% of variance in mental component summary was explained by the same seven variables with physical functioning and pain contributing the most. Only 19% of the variance for physical component summary was explained by five variables (age, body mass index, surgery, lymphedema, and muscle strength) with body mass index and muscle strength contributing the most at two years. Results provide information to help nurses formulate extended interventions and education for improving the perceptions and objective outcomes of women after undergoing axillary surgery for breast cancer.
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