Abstract: Background　There are many tools for assessing upper limb function in breast cancer patients，but there is a lack of standardized comparative studies on the development and reporting quality of these tools，which hampers comprehensive appraisal and evidence-based recommendations. Objective　To systematically review upper limb function assessment tools for breast cancer patients，so as to provide guidance for clinicians and nurses in selecting appropriate instruments. Methods　We searched CNKI，Wanfang Data，VIP，CBM，PubMed，MEDLINE，Embase，the Cochrane Library，Web of Science，and CINAHL for studies of upper limb function assessment instruments in breast cancer patients，covering each database from inception through March 24，2025. Dual independent screening and data abstraction were undertaken，after which methodological quality and psychometric properties were assessed in line with COSMIN. A modified Grading of Recommendations Assessment，Development and Evaluation（GRADE） approach was then applied to rate the quality of evidence and formulate recommendations. Results　A total of 21 studies were included，comprising nine generic instruments and four breast cancer-specific instruments. The generic instruments included the Quick Disability of Arm，Shoulder and Hand（Quick-DASH），the Disability of Arm，Shoulder and Hand（DASH），Kwan's Arm Problem Scale（KAPS），the Upper Limb Functional Index（ULFI），the Norman Questionnaire（NQ），the Patient-Specific Functional Scale（PSFS），the Upper Extremity Functional Index （UEFI），the Oxford Shoulder Score（OSS），and the Shoulder Pain and Disability Index（SPADI）. The breast cancer-specific instruments included the Functional Assessment of Cancer Therapy-Breast+4 Upper Limb subscale（FACT-B+4-UL），the Lymphedema Functioning，Disability and Health Questionnaire（Lymph-ICF），the Lymphedema and Breast Cancer Questionnaire（LBCQ），and the LYMPH-Q Upper Extremity Module. The Lymph-ICF and the LYMPH-Q Upper Extremity Module were recommended as Category A. The ULFI was classified as Category C due to high-quality evidence demonstrating inadequate structural validity，and the LBCQ was also classified as Category C due to high-quality evidence of inadequate internal consistency. All remaining tools were recommended as Category B. Conclusion　Compared with the other assessment tools，the Lymph-ICF and the LYMPH-Q Upper Extremity Module demonstrated more comprehensive psychometric properties with good reliability and validity，and can be provisionally recommended for use. However，additional high-quality evidence is still required to further explore assessment tools for upper limb function in breast cancer patients.

Key words: Breast Cancer, Upper Limb Function, Assessment Tool, Measurement Properties, COSMIN Guideline, Systematic Review

摘要： 背景　国内外用于评估乳腺癌上肢功能的工具较多，但既往测量工具的开发和报告质量参差不齐，尚缺乏对工具全面和规范的比较，导致缺乏系统性的介绍和推荐。目的　对乳腺癌患者上肢功能评估工具进行系统评价，为临床医护人员遴选合适的评估工具提供参考。方法　在中国生物医学文献数据库、万方数据知识服务平台、中国知网、维普网、PubMed、Embase、MEDLINE、Web of Science、CINAHL、Cochrane Library平台检索乳腺癌患者上肢功能评估工具相关研究，检索时间为建库至2025-03-24。由2名研究人员独立筛选文献，提取数据，按照基于共识的健康测量工具遴选标准，对纳入研究开展方法学质量和测量学属性评价，并依据证据等级综合判定，提出推荐意见。结果　共纳入21项研究，包括9项普适性评估工具和4项特异性评估工具。普适性评估工具分别为DASH简式评分表（Quick-DASH），手臂、肩部和手部残疾问卷（DASH），Kwan手臂问题量表（KAPS），上肢功能指数（ULFI），Norman问卷（NQ），患者特异性功能量表（PSFS），上肢功能指数（UEFI），牛津肩部评分（OSS），肩部疼痛和残疾指数（SPADI）；特异性评估工具分别为癌症治疗功能评估量表-乳腺癌+4-上肢分量表（FACT-B+4-UL），淋巴水肿功能、残疾和健康问卷（Lymph-ICF），淋巴水肿和乳腺癌问卷（LBCQ），LYMPH-Q上肢模块（LYMPH-QUpper Extremity Module）。通过评估，Lymph-ICF和LYMPH-Q Upper Extremity Module为A级推荐；ULFI的结构效度有高质量证据证实为“不充分”，LBCQ的内部一致性有高质量证据证实为“不充分”，为C级推荐，其余量表作为B级推荐。结论　可暂时推荐使用Lymph-ICF和LYMPH-Q Upper Extremity Module问卷，但仍需更多高质量证据来进一步探究乳腺癌患者上肢功能的评估工具。

关键词: 乳腺癌, 上肢功能, 评估工具, 测量学属性, COSMIN 指南, 系统评价