Psychometric Properties and Further Validation of the Arm Morbidity following Breast Cancer Treatment (ARM- BCT) Tool

Purpose Breast cancer is the most common malignancy among women globally. While advancements in treatment have improved survival rates, many survivors experience physical morbidities that significantly affect their recovery. This study aimed to validate and evaluate the psychometric properties of the Arm Morbidity following Breast Cancer Treatment (ARM-BCT) tool. Methods A total of 202 female patients, aged 18 to 80 years, who had undergone oncological breast surgery 6 to 36 months prior, were recruited. Participants completed questionnaires, including the ARM-BCT, and underwent functional assessments to evaluate outcomes such as pain, lymphedema, range of motion, and grip strength. The validity of the ARM-BCT was tested using regression models to evaluate its ability to predict morbidity based on outcome measures. Results The ARM-BCT effectively identified differences between low- and high-risk groups for morbidity, including decreased function (OR 1.7, P < 0.001, 95% CI 1.454; 2.043), pain (OR 1.7, P < 0.001, 95% CI 1.454; 2.043), lymphedema, decreased arm strength (OR 1.5, P < 0.001, 95% CI 1.320; 1.747), and reduced performance on the 30-second sit-to-stand test (P < 0.001, β = 0.358) and grip strength (P < 0.001, β = 0.462). The ARM-BCT demonstrated good accuracy with an Area Under the Curve of 0.872 (95% CI: 0.820–0.892, P < 0.001) with sensitivity of 0.986 and specificity of 0.818. Conclusions The ARM-BCT is a reliable and valid tool for identifying breast cancer survivors at risk of arm morbidity. Early detection of these morbidities holds promise for improving recovery through tailored rehabilitation strategies.