Defense Date

1975

Document Type

Thesis

Degree Name

Master of Science

First Advisor

Otto Payton

Abstract

Thirty female outpatients with metastatic breast carcinoma were evaluated using two operational models constructed for the purpose of assessing and assigning a quantitative score for (A) extent of metastatic disease and (B) level of functional disability. These patients were drawn from the population of patients with disseminated breast carcinoma attending the medical oncology clinics at the Medical College of Virginia Tumor Clinics for a 49 day period in 1975. The data from this patient sample were used to test several hypotheses.

Each patient underwent an initial screening procedure designed to clearly identify those patients with disseminated disease. This was followed by a preliminary evaluation involving related background information. The selected patient sample was then evaluated and scored on the operational models.

The numerical data were tabulated and statistically analyzed for the full patient sample and subsequently for inclusive groupings using the following parameters: age, length of disease, length of disease free interval, duration of metastatic disease, clinic attended, and major metastatic sites. In addition, the distribution of the patient sample over functional classification categories, the frequency of specific disabilities, and related sample characteristics were tabulated and analyzed.

A summary of the major findings of this research project are enumerated below:

1. There is a positive statistical correlation between the extent of metastatic disease and the level of disability and physical dysfunction for the full sample of patients with metastatic breast carcinoma.

2. Those patients over the age of 60, and those patients having their disease longer than 3.3 years do not exhibit significantly greater levels of functional disability than those patients under the age of 60 or those patients having their disease less than 3.3 years.

3. The length of the disease free interval, the duration of metastatic disease, and the tumor clinic attended did not have a significant effect on the extent of metastases or the level of physical dysfunction in these patients.

4. For each of the six major metastatic sites (lung, pleura, bone, liver, brain, and distant lymphatic or skin and soft tissue), there was a positive statistical correlation between the extent of metastatic disease and the level of physical dysfunction. The value for r exceeded .7 and was significant for each group except Group PD — those patients with pleural effusions.

5. Patients with pleural effusions had significantly less metastatic disease in comparison to the full patient sample. These patients also correlated the lowest between extent of metastases and level of functional disability.

6. Patients with liver metastases showed the highest correlation coefficient of any of the other groups; this value was significantly different from the full patient sample correlation coefficient.

7. Patients with brain metastases had significantly greater amounts of metastatic disease, and significantly greater levels of functional disability in comparison to all patients combined.

8. Patients with pleural effusions or bone metastases were less likely to have several additional anatomical sites involved with metastatic tumor.

9. Patients with lung, liver, brain, or skin and soft tissue — distant lymphatic involvement were more likely to have several additional anatomical sites involved with metastatic tumor.

10. There was a statistically uneven distribution of patients over a six category functional classification schema, the majority of patients not being severely dysfunctional.

11. Approximately three fourths of the patients with metastatic breast carcinoma would have the supportive goal selected for their rehabilitation needs.

12. Approximately one fourth of the patients could be classified as terminal or preterminal and would have the palliative goal selected for their rehabilitation needs.

13. Less than one third of the patient sample could be classified in performance status levels which would indicate that they need assistance of some kind to care for their personal needs, carry on normal daily activities, or return to part time employment, duties, or age-appropriate tasks. The physical therapy needs for this group are correspondingly greater.

Comments

Scanned, with permission from the author, from the original print version, which resides in University Archives.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

4-21-2017

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