Comparison between Two Methods to Evaluate Function in Postoperative Breast Cancer Survivors

Abstract

Introduction Treatment for breast cancer can cause adverse effects such as pain and reduced upper limb function which can affect activities of daily living. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is the most used tool for evaluating function in breast cancer survivors. However, some specific aspects have raised discussions about its restricted coverage, which can generate several biases. Objective To determine if DASH scores differed when assessed before and after task‐oriented training (TOT) at 3 and 6 months after breast cancer surgery. Design Prospective cohort study. Setting Institutional study of 22 women assessed at 3 and 6 months after breast cancer surgery. Main Outcome Measures The DASH questionnaire and TOT assessment. Two correlation tests were performed: Spearman's correlation between the total score of the two DASH scores (pre‐ and post‐TOT) and the Kendall's tau correlation between each of the items. Results There was a moderate and excellent correlation between final DASH scores, pre‐ and post‐TOT, at both 3 and 6 months postoperatively. However, when assessed individually, most of the DASH items were poorly correlated. There was also no agreement between the total DASH scores pre‐ and post‐TOT as assessed by Bland‐Altman plots. Conclusion Both the DASH and TOT are considered useful in clinical practice to assess upper limb function, although the use of TOT in some of the DASH items may reduce memory bias and improve skills estimation.