Comparison between two methods to evaluate function in postoperative breast cancer survivors

Introduction: Treatment for breast cancer can generate adverse effects as pain and loss of upper limb functionality and affect the dynamics of daily life activities. The DASH questionnaire is the most used tool for evaluating functionality in breast cancer survivors. However, some specific aspects have raised discussions about its restricted coverage, which can generate several biases.

Objective: To analyse the relation and agreement of two DASH scores, which was assessed before and after a simulation of task-oriented training (TOT) at 3 and 6 months postoperatively.

Design: Prospective cohort study.

Setting: Institutional study involving 22 women assessed at 3 and 6 months postoperatively after breast cancer surgery.

Main outcome measures: The DASH questionnaire and TOT assessment.

Results: 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. There was a moderate and excellent relation between final DASH scores, pre and post TOT, at 3 and 6 months postoperatively, respectively. Though, most of DASH items, when assessed individually, had a poor relation. Some items presented a negative relation, although without statistical significance. There was no agreement between the total DASH scores pre and post TOT.

Conclusion: Both assessments are considered useful in clinical practice, but the TOT might be most promising for enhancing functional evaluation in this population, reducing the memory bias and improving skills estimation. This article is protected by copyright. All rights reserved.

Keywords: Breast cancer; Disabilities of the Arm, Shoulder and Hand Questionnaire. Task oriented training; Self-evaluation.