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Table 3 Fully adjusted associations of baseline sociodemographic, tumour and treatment characteristics with first self-reported ASP

From: Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study

 

No. women with outcome/total

Fully adjusted CHR (95%CI)a,b

Shoulder/arm pain

Arm stiffness

Arm/hand swelling

Shoulder/arm pain

Arm stiffness

Arm/hand swelling

Study site, ethnicity

         

Namibia Black

151/380

148/380

81/380

1

 

1

 

1

0.001

Namibia Non-Black

25/97

26/97

13/97

0.71 (0.46–1.10)

 < 0.0001

0.78 (0.50–1.20)

0.0002

0.68 (0.37–1.24)

 

Uganda

214/418

184/418

103/418

2.00 (1.61–2.48)

 

1.52 (1.21–1.90)

 

1.59 (1.18–2.15)

 

Nigeria

162/383

106/383

84/383

1.88 (1.48–2.39)

 

1.06 (0.81–1.39)

 

1.69 (1.21–2.34)

 

Zambia

66/198

52/198

38/198

1.19 (0.88–1.61)

 

0.91 (0.66–1.27)

 

1.35 (0.90–2.03)

 

Age at diagnosis (years)

         

 < 50

307/780

255/780

157/780

1

0.06

1

0.23

1

0.10

 ≥ 50

311/696

261/696

162/696

1.18 (0.99–1.39)

 

1.12 (0.93–1.35)

 

1.22 (0.96–1.53)

 

per 10 years increase

618/1476

516/1476

319/1476

1.04 (0.98–1.11)

0.21

1.04 (0.97–1.11)

0.31

1.04 (0.95–1.13)

0.43

BMI (Kg/m2)

         

 < 25

273/637

229/637

129/637

1

0.37

1

0.30

1

0.41

[25–30[

176/426

144/426

95/426

0.88 (0.72–1.06)

 

0.89 (0.72–1.09)

 

1.04 (0.79–1.35)

 

30 + 

140/342

120/342

80/342

0.99 (0.80–1.21)

 

1.07 (0.85–1.34)

 

1.21 (0.91–1.60)

 

per 5 kg/m2 increase

618/1476

516/1476

319/1476

1.00 (0.93–1.07)

0.94

1.03 (0.96–1.12)

0.40

1.11 (1.01–1.22)

0.03

Education

         

University/technical

106/317

84/317

66/317

1

 

1

 

1

0.07

Secondary/high school

196/502

161/502

95/502

1.48 (1.16–1.88)

 

1.41 (1.08–1.84)

 

1.08 (0.78–1.49)

 

None/Primary school

316/657

271/657

158/657

1.94 (1.51–2.49)

 

1.77 (1.34–2.33)

 

1.41 (1.02–1.96)

 

Per decrease in educational level

618/1476

516/1476

319/1476

1.38 (1.22–1.56)

 < 0.0001

1.32 (1.16–1.51)

 < 0.0001

1.20 (1.02–1.41)

0.03

HIV status at breast cancer diagnosis

         

Negative/Unknown

562/1332

460/1332

291/1332

1

0.85

1

0.14

1

 > 0.99

Positive

56/144

56/144

28/144

0.97 (0.73–1.29)

 

1.24 (0.93–1.65)

 

1.00 (0.67–1.49)

 

Ever diagnosed with hypertension

         

No

432/1050

363/1050

215/1050

1

0.11

1

0.99

1

0.15

Yes

186/426

153/426

104/426

1.17 (0.96–1.42)

 

1.00 (0.81–1.23)

 

1.22 (0.93–1.58)

 

Tumour stage at diagnosis

         

Localized

91/275

79/275

40/275

1

 < 0.0001

1

 < 0.0001

1

 < 0.0001

Locally advanced

413/903

343/903

207/903

1.70 (1.35–2.14)

 

1.66 (1.29–2.13)

 

1.98 (1.40–2.79)

 

Metastatic

79/203

68/203

48/203

2.44 (1.78–3.33)

 

2.69 (1.92–3.77)

 

4.02 (2.59–6.23)

 

Prior treatment

         

No

105/237

75/221

41/197

1

0.01

1

0.08

1

0.01

Yes

496/1168

429/1184

270/1208

1.37 (1.08–1.72)

 

1.27 (0.97–1.67)

 

1.67 (1.16–2.41)

 

Prior surgeryc

         

No

248/512

185/497

116/482

1

0.01

1

0.21

1

0.19

Yes

309/786

280/801

173/816

0.76 (0.63–0.92)

 

0.87 (0.70–1.08)

 

0.83 (0.63–1.09)

 

Prior radiotherapy

         

No

397/854

316/850

186/825

1

0.60

1

0.22

1

0.59

Yes

147/421

135/425

86/450

1.07 (0.83–1.38)

 

0.85 (0.65–1.10)

 

1.10 (0.77–1.59)

 

Prior chemotherapy

         

No

184/438

133/418

79/400

1

0.0002

1

0.001

1

0.001

Yes

370/873

327/893

206/911

1.48 (1.21–1.82)

 

1.48 (1.17–1.87)

 

1.65 (1.22–2.23)

 

Prior endocrine therapy

         

No

328/703

247/672

151/649

1

0.59

1

0.87

1

0.45

Yes

234/598

218/629

132/652

1.06 (0.86–1.29)

 

0.98 (0.79–1.22)

 

0.90 (0.68–1.18)

 

Sensitivity analysis conditioned on 6 months survival and excluding metastatic women

         

Prior treatment

         

Yes vs. No

419/1037

366/1039

214/1045

1.58 (1.14–2.18)

0.01

1.37 (0.95–1.98)

0.10

1.39 (0.86–2.24)

0.18

Prior surgery

         

Yes vs. No

280/769

254/771

149/776

0.77 (0.62–0.95)

0.02

0.92 (0.73–1.17)

0.50

0.84 (0.62–1.14)

0.26

Prior radiotherapy

         

Yes vs. No

125/382

116/380

76/401

0.83 (0.64–1.09)

0.18

0.70 (0.53–0.92)

0.01

0.91 (0.62–1.32)

0.61

Prior chemotherapy

         

Yes vs. No

339/813

300/813

178/821

1.67 (1.31–2.12)

 < 0.0001

1.52 (1.17–1.97)

0.002

1.59 (1.12–2.25)

0.01

Prior endocrine therapy

         

Yes vs. No

218/576

200/582

118/597

0.97 (0.79–1.19)

0.74

0.99 (0.80–1.23)

0.93

0.87 (0.65–1.15)

0.32

  1. CHR cause-specific hazard ratio, CI confidence interval
  2. aFor study site, age, BMI, education, tumour stage and prior treatment: fully adjusted CHRs are stratified on study site, and adjusted on age (continuous), BMI (categorical), education (continuous), tumour stage (categorical), and prior treatment
  3. bFor Prior surgery, prior radiotherapy, prior chemotherapy, Prior endocrine therapy: fully adjusted CHRs are stratified on study site, and adjusted on age (continuous), BMI (categorical), education (continuous), tumour stage (categorical), and mutually adjusted on each specific treatment type
  4. cOf women who received a surgery and reported an arm/shoulder pain during the follow-up, 84% had a mastectomy. For arm stiffness and arm/hand swelling, these percentages were, respectively, 89% and 87%
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Breast Cancer Research

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