Independent Student’s t-tests were performed to determine if differences were statistically significant when showing a normal distribution. Measurements that were not normally distributed were tested using the nonparametric Mann–Whitney U-test.

FHSQ Version 1.03 was used to obtain foot-related QoL scores. In all of the analyses, statistical significance was established with a P-value <0.01 and a confidence interval of 99%. All analyses were performed with a commercially available software (SPSS 19.0, Chicago, IL, USA).


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RESULTS

A total sample of 200 women aged between 33 and 80 years old, mean ± SD of 51.0±8.75 years, completed the study. This sample was divided into 100 women with breast cancer who were undergoing chemotherapy (for the case group) and 100 women without this pathology (healthy women for the control group). The sociodemographic characteristics of the participants is given in Table 1, and the characteristics did not show any statistically significant differences for age, weight, height, or BMI (P<0.01).

(To view a larger verion of Table 1, click here.)

The results of the comparison between FHSQ scores from both groups are shown in Table 2. In section 1 of the FHSQ, four specific domains regarding the foot, ie, pain, function, health, and footwear, were evaluated. FHSQ scores were higher for foot pain, foot function, and general foot health for healthy women compared to women with breast cancer. Section 2 assessed four domains of general well-being (overall health, physical function, social capacity, and vigor). Specifically, FHSQ scores were lower in all domains (general health, physical activity, social capacity, and vigor) for women undergoing chemotherapy compared to healthy women.

(To view a larger verion of Table 2, click here.)

The women with breast cancer undergoing chemotherapy treatment showed a lower foot health-related QoL. Statistically significant differences between cancer and control groups were shown for foot pain (P=0.003), foot function (P<0001), physical activity (P<0.001), social capacity (P<0.001), and vigor (P=0.001). The rest of the domains did not show any statistically significant differences between the two groups (P≥0.01).

Considering the case group, this study also revealed that 94% (n=100) of the participants reported having foot problems since they had started chemotherapy. Consequently, a physical examination revealed that the most frequent alterations in the feet were nail abnormalities (46%, including nail plate color change, onychogryphosis, onychocryptosis, or onychomycosis), generalized pain (36%), cracks and dryness (20%), paresthesia (19%), inflammation (10%), varices (8%), deformed fingers (7%), and helomas and hardness (4%). These pathologies were the most frequent, and some patients suffered from more than one of these conditions at the same time. Although less frequent in the feet, other pathologies observed after chemotherapy included cramps, loss of sensation, blistering, change in skin coloration, and/or loss of hair and papillomas (only in isolated cases). Furthermore, 4% of patients did not present any of these signs and symptoms after chemotherapy, and thus did not undergo any preventive measures.