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Risk factors for early postoperative psychological problems in breast cancer patients after axillary lymph node dissection

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Abstract

Background

The purpose of this study was to investigate the factors related to early postoperative psychological conditions in breast cancer patients with axillary lymph node dissection 3 months after the surgery.

Methods

The subjects of this study were 200 consecutive patients who underwent axillary lymph node dissection for breast cancer at our hospital. Age, body mass index, surgical side, work, marriage, presence of children, presence of co-resident household members, resection of the pectoralis minor muscle, preoperative chemotherapy, postoperative chemotherapy, postoperative hormonal therapy, postoperative radiotherapy, shoulder range of motion, upper limb function (Disabilities of the Arm, Shoulder and Hand; DASH), and psychological conditions were evaluated. In this study, a Distress and Impact Thermometer was used to classify patients with adjustment disorders, depression, or major depression and suicidal ideation into a group with psychological problems and the remaining patients into a group with no psychological problems.

Results

Logistic regression analysis showed that only DASH was statistically significantly associated with psychological conditions (p < 0.05). Using receiver operating characteristic curve analysis, a DASH score of 18 or greater was found to be very specific for predicting psychological conditions.

Conclusions

The observation that somatic symptoms and disability of upper limb function are related to psychological conditions may indicate the importance of postoperative rehabilitation in breast cancer patients with axillary lymph node dissection.

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Acknowledgements

We would like to thank all of the patients who participated for their cooperation.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Division of Physical Therapy, Kochi Professional University of Rehabilitation, Otu-1139-3, Takaoka-Machi, Tosa, 781-1102, Kochi, Japan

    Yoshiteru Akezaki

  2. Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Japan

    Eiji Nakata

  3. Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ko-160, Minamiumemoto-Machi, Matsuyama, Ehime, Japan

    Masato Kikuuchi, Ritsuko Tominaga, Hideaki Kurokawa, Makiko Hamada & Shinsuke Sugihara

  4. Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Ko-160, Minamiumemoto-Machi, Matsuyama, Ehime, Japan

    Kenjiro Aogi & Shozo Ohsumi

Authors
  1. Yoshiteru Akezaki
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  2. Eiji Nakata
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  3. Masato Kikuuchi
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  4. Ritsuko Tominaga
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  5. Hideaki Kurokawa
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  6. Makiko Hamada
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  7. Kenjiro Aogi
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  8. Shozo Ohsumi
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  9. Shinsuke Sugihara
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Contributions

YA, EN, and MK contributed to the study conception and design, wrote the manuscript, and analyzed the data. RT, HK, and MH were involved in data collection and processing. KA, SO, and SS have revised critically the manuscript for important intellectual content. All authors contributed to the writing of the manuscript.

Corresponding author

Correspondence to Yoshiteru Akezaki.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

Shikoku Cancer Center Ethics Committee approved the study, and written, informed consent was obtained from each participant (Approval no. 2018-45).

Informed consent

Informed consent was obtained from all patients.

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Akezaki, Y., Nakata, E., Kikuuchi, M. et al. Risk factors for early postoperative psychological problems in breast cancer patients after axillary lymph node dissection. Breast Cancer 27, 284–290 (2020). https://doi.org/10.1007/s12282-019-01020-y

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  • DOI: https://doi.org/10.1007/s12282-019-01020-y

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