Physical symptoms and working performance in female breast cancer survivors: a systematic review

<b>Purpose:</b> The aim of this systematic review was to summarize and systematize the information about physical symptoms and its relation with work activity on female Breast Cancer Survivors (BCS). <b>Methods:</b> A systematic search was performed on the databases MEDLINE/PubMed (via National Library of Medicine), SCOPUS (Elsevier), Web of Science (Thomson Reuters Scientific) and CINAHL with full text (EBSCO), including papers about physical impairments experienced by female workers who have had breast cancer. <b>Results:</b> The search retrieved 238 studies, and another 5 were identified in the articles’ references, totaling 243 papers. After removing duplicates and applying the inclusion criteria and a full text reading, 13 articles were included for qualitative analysis. Concerning physical limitations, most complaints were related to the elevation of upper limbs, carrying heavy objects, driving and holding manual movements. The most referred symptoms were breast/arm pain, fatigue, lymphedema, reduced range of motion and weakness in the upper limbs, scar tissue adherence in the breast/axilla and paresthesia in the arm/breast. <b>Conclusion:</b> These symptoms and physical limitations led to the difficulty or impossibility of performing work tasks, which also diminished work productivity, as well as the increase in time to return to work. The present results suggest higher unemployment rates and the need for modifying work conditions.Implication for RehabilitationHealth professionals should include risk assessment at daily routine to identify possible sources of physical impairments for upper limbs.Provide the support and orientations according to personal and job characteristics of the patient.Focus the aims of treatment over upper limbs impairments, reducing the prevalence and the gravity of symptoms. Health professionals should include risk assessment at daily routine to identify possible sources of physical impairments for upper limbs. Provide the support and orientations according to personal and job characteristics of the patient. Focus the aims of treatment over upper limbs impairments, reducing the prevalence and the gravity of symptoms.

**研究目的：** 本系统综述旨在系统性梳理并总结女性乳腺癌幸存者（BCS）的躯体症状表现，及其与工作活动的关联信息。
**研究方法：** 本研究通过美国国立医学图书馆的MEDLINE/PubMed、爱思唯尔旗下的SCOPUS、汤森路透科学事业部的Web of Science，以及EBSCO平台的全文版CINAHL数据库开展系统性检索，纳入所有针对曾患乳腺癌的女性劳动者所经历的躯体功能损害的相关研究文献。
**研究结果：** 本次检索共获取238项研究，另从纳入文献的参考文献中补充识别5项，最终累计获得243篇文献。经去重处理、纳入标准筛选及全文通读后，最终纳入13篇文献进行定性分析。关于躯体功能受限情况，受试者最常见的主诉涉及上肢抬举、重物搬运、驾驶作业及持续手工操作。最常被报告的症状包括乳房/手臂疼痛、疲劳、淋巴水肿、上肢活动范围受限与肌力减退、乳房/腋窝瘢痕组织粘连，以及手臂/乳房区域感觉异常。
**研究结论：** 上述症状与躯体功能受限会导致工作任务的完成困难或无法完成，同时降低工作生产率，并延长重返工作岗位的周期。本研究结果提示，女性乳腺癌幸存者的失业率更高，且亟需对工作条件进行针对性调整。
康复启示：
医疗卫生专业人员应在日常诊疗流程中纳入风险评估环节，以识别上肢躯体功能损害的潜在诱因；需结合患者的个体特征与工作岗位特点，提供个性化支持与指导；治疗应以改善上肢功能损害为核心目标，降低症状的发生率与严重程度。医疗卫生专业人员应在日常诊疗流程中纳入风险评估环节，以识别上肢躯体功能损害的潜在诱因；需结合患者的个体特征与工作岗位特点，提供个性化支持与指导；治疗应以改善上肢功能损害为核心目标，降低症状的发生率与严重程度。