Abstract
Aging women face increased risks of both breast cancer and spinal cord injury (SCI). Unique treatment challenges for this population warrant consideration. Despite advances in breast cancer treatments, significant adverse health outcomes continue to occur. Cancer treatments can be detrimental to the quality of life of able-bodied women, but more so for women living with pre-existing SCI. The goal of this Perspective Paper is to inform rehabilitation professionals about the needs of women with SCI treated for breast cancer. Specific objectives were: (1) give an overview of breast cancer treatment-related adverse outcomes that need special attention in women with SCI; and (2) inspire researchers to study the consequences of breast cancer-related health conditions in women with SCI. We identified SCI-specific considerations for undergoing breast cancer surgery, chemotherapy, radiation and endocrine therapy. This paper attempts to raise awareness regarding these issues due to the lack of research attention they have received.
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References
Noonan VK, Fingas M, Farry A, Baxter D, Singh A, Fehlings MG, et al. Incidence and prevalence of spinal cord injury in Canada: a national perspective. Neuroepidemiology. 2012;38:219–26.
Van Den Berg MEL, Castellote JM, Mahillo-Fernandez I, De, Pedro-Cuesta J. Incidence of spinal cord injury worldwide: a systematic review. Neuroepidemiology. 2010;34:184–92.
DeSantis CE, Ma J, Gaudet MM, Newman LA, Miller KD, Goding Sauer A, et al. Breast cancer statistics, 2019. CA Cancer J Clin. 2019;69:438–51.
Xu X, Mann JR, Hardin JW, Gustafson E, McDermott SW, Deroche CB. Adherence to US Preventive Services Task Force recommendations for breast and cervical cancer screening for women who have a spinal cord injury. J Spinal Cord Med. 2017;40:76–84.
Fisher MI, Capilouto G, Malone T, Bush H, Uhl TL. Comparison of upper extremity function in women with and women without a history of breast cancer. Phys Ther. 2020;100:500–8.
Florio J, Arnet U, Gemperli A, Hinrichs T. Need and use of assistive devices for personal mobility by individuals with spinal cord injury. J Spinal Cord Med. 2016;39:461–70.
Hidding JT, Beurskens CH, van der Wees PJ, van Laarhoven HW, Nijhuis-van der Sanden MW. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS ONE. 2014;9:e96748 https://doi.org/10.1371/journal.pone.0096748.
Gross SE, Pfaff H, Swora M, Ansmann L, Albert U, Gross-Kinkel A Health disparities among breast cancer patients with/without disabilities in Germany. Disability Health J. 2020; 13. https://doi.org/10.1016/j.dhjo.2019.100873.
Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.
Harrington S, Padua D, Battaglini C, Michener LA, Giuliani C, Myers J, et al. Comparison of shoulder flexibility, strength, and function between breast cancer survivors and healthy participants. J Cancer Surviv. 2011;5:167–74.
Levangie PK, Drouin J. Magnitude of late effects of breast cancer treatments on shoulder function: a systematic review. Breast Cancer Res Treat. 2009;116:1–15.
Wojcinski S, Nuengsri S, Hillemanns P, Schmidt W, Deryal M, Ertan K, et al. Axillary dissection in primary breast cancer: Variations of the surgical technique and influence on morbidity. Cancer Manag Res. 2012;4:121–7.
Andersen KG, Jensen MB, Tvedskov TF, Kehlet H, Gärtner R, Kroman N. Persistent pain, sensory disturbances and functional impairment after immediate or delayed axillary lymph node dissection. Eur J Surg Oncol. 2013;39:31–5.
Han ZA, Choi JY, Ko YJ. Dermatological problems following spinal cord injury in Korean patients. J Spinal Cord Med. 2015;38:63–7.
Wang JC, Chan RC, Tsai YA, Huang WC, Cheng H, Wu HL, et al. The influence of shoulder pain on functional limitation, perceived health, and depressive mood in patients with traumatic paraplegia. J Spinal Cord Med. 2015;38:587–92.
Berger A, Gerber L, Mayer D. Cancer‐related fatigue. Implications for breast cancer survivors. Cancer. 2012;118(8 suppl):2261–9.
Spei ME, Samoli E, Bravi F, La Vecchia C, Bamia C, Benetou V. Physical activity in breast cancer survivors: A systematic review and meta-analysis on overall and breast cancer survival. Breast. 2019;44:144–52.
Juhl AA, Christiansen P, Damsgaard TE. Persistent pain after breast cancer treatment: a questionnaire-based study on the prevalence, associated treatment variables, and pain type. J Breast Cancer. 2016;19:447–54.
Khan QJ, O’Dea AP, Sharma P. Musculoskeletal adverse events associated with adjuvant aromatase inhibitors. J Oncol. 2010;2010:65438.
Raj VS, Edeker J, Pugh TMA. Cancer-related fatigue. In: Central nervous system cancer rehabilitation. 2018, pp 121–31.
Hammell KW, Miller WC, Forwell SJ, Forman BE, Jacobsen BA. Fatigue and spinal cord injury: a qualitative analysis. Spinal Cord. 2009;47:44–9.
Smith EM, Imam B, Miller WC, Silverberg ND, Anton HA, Forwell SJ, et al. The relationship between fatigue and participation in spinal cord injury. Spinal Cord. 2016;54:457–62.
Carreira H, Williams R, Müller M, Harewood R, Stanway S, Bhaskaran K. Associations between breast cancer survivorship and adverse mental health outcomes: a systematic review. J Natl Cancer Inst. 2018;110:1311–27.
Cameron AP, Rodriguez GM, Gursky A, He C, Clemens JQ, Stoffel JT. The severity of bowel dysfunction in patients with neurogenic bladder. J Urol. 2015;194:1336–41. https://doi.org/10.1016/j.juro.2015.04.100.
Iezzoni LI, Kilbridge K, Park ER. Physical access barriers to care for diagnosis and treatment of breast cancer among women with mobility impairments. Oncol Nurs Forum. 2010;37:711–7.
Miltenburg NC, Boogerd W. Chemotherapy-induced neuropathy: a comprehensive survey. Cancer Treat Rev. 2014;40:872–82.
de Padua AL, Strickland K, Patrick M, Ditunno JF. Spinal cord injured women’s treatment of breast carcinoma: alert to complications. Spinal Cord Ser Cases. 2018;4:46.
Lucas AS, Lacouture M, Thompson J, Schneider SM. Radiation dermatitis: a prevention protocol for patients with breast cancer. Clin J Oncol Nurs. 2018;22:429–37.
Gustafson C, Jadhav R, Cao W, Pegram M, Tian L, Weynard C, et al. Immune cell repertoires in breast cancer patients after adjuvant chemotherapy. JC Insight. 2020 https://doi.org/10.1172/jci.insight.134569.
Suskin J, Shapiro CL. Osteoporosis and musculoskeletal complications related to therapy of breast cancer. Gland Surg. 2018;7:411–23.
Soleyman-Jahi S, Yousefian A, Maheronnaghsh R, Shokraneh F, Zadegan SA, Soltani A, et al. Evidence-based prevention and treatment of osteoporosis after spinal cord injury: a systematic review. Eur Spine J. 2018;27:1798–814.
Hadji P, Aapro MS, Body JJ, Gnant M, Brandi ML, Reginster JY, et al. Management of aromatase inhibitor-associated bone loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG. J Bone Oncol. 2017;7:1–12.27.
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BS was responsible for conceiving this Perspectives paper, overseeing the input of topics for the paper and literature review, supervising the writing and editing of the manuscript. AWS and CE conducted the literature review and were the key contributors to the writing of the manuscript. SS assisted with developing the article topic, provided input to content and offered feedback on the literature review and edited manuscript. TS had a role in initiating the project and editing of the manuscript. SH provided input to content, contributed to the writing and editing of the manuscript.
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Sawatzky, B., Edwards, C.M., Walters-Shumka, A.T. et al. A perspective on adverse health outcomes after breast cancer treatment in women with spinal cord injury. Spinal Cord 59, 700–704 (2021). https://doi.org/10.1038/s41393-021-00628-2
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DOI: https://doi.org/10.1038/s41393-021-00628-2
