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Izano M, Satariano WA, Hiatt RA, et al. The impact of functional limitations on long-term outcomes among African-American and white women with breast cancer: a cohort study. BMJ Open. 2013;3(10):e003232doi: 10.1136/bmjopen-2013-003232.
Izano, M., Satariano, W. A., Hiatt, R. A., & Braithwaite, D. (2013). The impact of functional limitations on long-term outcomes among African-American and white women with breast cancer: a cohort study. BMJ open, 3(10), e003232. https://doi.org/10.1136/bmjopen-2013-003232
Izano, Monika, et al. "The impact of functional limitations on long-term outcomes among African-American and white women with breast cancer: a cohort study." BMJ open vol. 3,10 (2013): e003232. doi: https://doi.org/10.1136/bmjopen-2013-003232
Izano M, Satariano WA, Hiatt RA, Braithwaite D. The impact of functional limitations on long-term outcomes among African-American and white women with breast cancer: a cohort study. BMJ Open. 2013 Oct 10;3(10):e003232. doi: 10.1136/bmjopen-2013-003232. PMID: 24114369; PMCID: PMC3796273.
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BMJ Open. 2013 Oct 10;3(10):e003232. doi: 10.1136/bmjopen-2013-003232.

The impact of functional limitations on long-term outcomes among African-American and white women with breast cancer: a cohort study.

BMJ open

Monika Izano, William A Satariano, Robert A Hiatt, Dejana Braithwaite

Affiliations

  1. Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.

PMID: 24114369 PMCID: PMC3796273 DOI: 10.1136/bmjopen-2013-003232

Abstract

OBJECTIVES: We examined the impact of functional limitations and functional decline during the first year following breast cancer diagnosis on the risk of mortality from breast cancer and other causes among African-American and white women, respectively.

DESIGN: The Health and Functioning in Women (HFW) cohort study.

SETTING: Detroit, Michigan, USA.

PARTICIPANTS: A total of 162 African-American and 813 white women aged 40-84 years with newly diagnosed breast cancer identified through the Metropolitan Detroit Cancer Surveillance System over a 7-month period between 1984 and 1985 and followed for up to 28 years (median 11 years).

OUTCOME MEASURES: Risk of mortality from breast cancer and other causes.

RESULTS: Statistically significant increases in the risk of other-cause mortality were found for each unit increase in the number of self-reported functional limitations (HR=1.08, 95% CI 1.03 to 1.14), 0 vs ≥1 functional limitations (HR=1.47, 95% CI 1.13 to 1.91), difficulty in pushing or pulling large objects (HR=1.34, 95% CI 1.04 to 1.73), writing or handling small objects (HR=1.56, 95% CI 1.00 to 2.44), and walking half a mile (HR=1.60, 95% CI 1.19 to 2.14). Functional limitations and functional decline did not explain racial disparities in the survival of this cohort. Functional decline was associated with increased risk of other-cause mortality in women with regional and remote disease but not in women with localised disease. Whereas measures of functional limitation were not associated with breast cancer-specific mortality, each unit of functional decline (HR=1.17, 95% CI 1.05 to 1.31) and decline in the ability to sit ≥1 h (HR=2.06, 95% CI 1.13 to 3.76) were associated with increased risk of breast cancer-specific mortality. Measures of functional decline were associated with increased risk of breast cancer mortality in overweight and obese women, but not in women of normal weight.

CONCLUSIONS: Whereas functional limitations were associated with increased risk of other-cause mortality, functional decline was associated with increased risk of breast cancer mortality.

Keywords: Functional decline; Functional limitations; Mortality; Survival

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