Arm morbidity after breast conservation and axillary therapy

Thompson, Alastair; Air, M.; Jack, W; Kerr, G.R.; Rodger, A.; Chetty, U.

doi:10.1016/s0960-9776(95)80003-4

Cited by 34 publications

(13 citation statements)

References 21 publications

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“…The mobility of the arm was preserved better in our patients than reported previously (Hladiuk et al, 1992;Thompson et al, 1995). This could be a result of the active physiotherapy that was included in the rehabilitation programme.…”

Section: Discussionsupporting

confidence: 47%

“…However, follow-up studies indicate that some women suffer from various chronic treatment-related symptoms such as pain, sensory disturbances, oedema and muscle weakness, the reported incidence of which varies from 5 to 74% (Olsen et al, 1993;Thompson et al, 1995). Recently, Stevens et al (1995) reported a 20% prevalence rate of the post-surgical pain syndrome in 95 women after breast surgery.…”

mentioning

confidence: 99%

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Pain and other symptoms during the first year after radical and conservative surgery for breast cancer

Tasmuth

Smitten²,

Kalso³

1996

Br J Cancer

243

162

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Summary This study assessed pain, neurological symptoms, oedema of the ipsilateral arm, anxiety and depression occurring in women treated surgically for breast cancer, the impact of these symptoms on daily life and how they evolved during the 1 year follow-up. Ninety-three consecutive patients with non-metastasised breast cancer who were treated during 1993 -94 were examined before surgery and after 1, 6 and 12 months. They were asked about pain, neurological symptoms and oedema in the breast scar region and/or ipsilateral arm. Sensory testing was performed, and gripping force and the circumference of the arm were measured. Anxiety and depression were evaluated. One year after surgery, 80% of the women had treatment-related symptoms in the breast scar region and virtually all patients had symptoms in the ipsilateral arm. The incidence of chronic post-treatment pain was higher after conservative surgery than after radical surgery (breast area: 33% vs 17%, NS; ipsilateral arm: 23% vs 13%, NS). Numbness occurred in 75% and oedema of the ipsilateral arm in over 30% of the patients after both radical and conservative surgery. Phantom sensations in the breast were reported by 25% of the patients. No difference in psychic morbidity was detected after the two types of surgery. Both the anxiety and depression scores were highest before surgery, decreasing with time, and were significantly correlated with preoperative stressful events.Keywords: breast cancer; breast surgery; chronic pain; quality of life Several recent studies (Rayter et al., 1990;Kuusk et al., 1992;Fisher et al., 1995) found no significant differences in the overall or disease-free survival between patients treated with either total mastectomy or breast-conserving surgery with breast radiation. However, follow-up studies indicate that some women suffer from various chronic treatment-related symptoms such as pain, sensory disturbances, oedema and muscle weakness, the reported incidence of which varies from 5 to 74% (Olsen et al., 1993;Thompson et al., 1995). Recently, Stevens et al. (1995) reported a 20% prevalence rate of the post-surgical pain syndrome in 95 women after breast surgery. The incidence of chronic pain did not differ statistically significantly after mastectomy compared with lumpectomy. In our recent retrospective study, in which 467 women completed a questionnaire on post-treatment symptoms 10-58 months after surgery, pain, paraesthesiae or strange sensations were reported by half of the patients. These chronic treatment-related symptoms were more common after breast resection (BCT) than after modified radical mastectomy (MRM) (Tasmuth et al., 1995). The incidence of pain in the operated breast area after both types of surgery and in the ipsilateral arm after MRM was higher if less time had elapsed since surgery. About 25% of the patients in this study reported chronic pain that affected their daily lives at least moderately.A few studies have examined the time course of various post-treatment symptoms following treatment of breast cancer...

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Section: Discussionsupporting

confidence: 47%

mentioning

confidence: 99%

Pain and other symptoms during the first year after radical and conservative surgery for breast cancer

Tasmuth

Smitten²,

Kalso³

1996

Br J Cancer

243

162

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“…The sEMG increases were attributed to either pain, fear of pain, muscular damage that altered muscle recruitment, or modified motor strategies. Reduced mobility amongst the BCP could also reflect damage to rotator cuff muscles (Thompson et al, 1995). Due to the depth, location and size of the rotator cuff muscles, EMG is best recorded with intramuscular electrodes, which had not been attempted prior to this current study.…”

Section: Introductionmentioning

confidence: 99%

Comparison of humeral rotation co-activation of breast cancer population and healthy shoulders

Brookham

Dickerson

2016

Journal of Electromyography and Kinesiology

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“…MRM, memenin tamamı ve koltuk altındaki lenf nodlarının alındığı, pektoralis major kasının korunduğu, MKC ise tümör ile birlikte çevresindeki bir miktar sağlam meme dokusunun çıkartılması (geniş lokal eksizyon, lumpektomi) ve aksiller lenf nodlarından meme ile ilgili olanlarının örneklenmesi işlemlerini içeren cerrahi yöntem tipidir. Her iki cerrahi yöntem de üst ekstremite morbiditesine neden olabilmektedir (7)(8)(9). Cerrahiye bağlı doku bütünlüğünün bozulması, omuz eklem kapsülünde gerilmeler, ağrı, nöral hasar, özellikle pektoralis major ve minör kaslarının çıkarıldığı mastektomi operasyonlarından sonra el kavrama gücünde azalma ve göğüs duvarında zayıflama hastanın omuz ve kol hareketlerini sınırlamaktadır (10)(11)(12).…”

Section: Introductionunclassified

“…Cerrahiye bağlı doku bütünlüğünün bozulması, omuz eklem kapsülünde gerilmeler, ağrı, nöral hasar, özellikle pektoralis major ve minör kaslarının çıkarıldığı mastektomi operasyonlarından sonra el kavrama gücünde azalma ve göğüs duvarında zayıflama hastanın omuz ve kol hareketlerini sınırlamaktadır (10)(11)(12). Omuz ağrısı ve eklem hareket kısıtlılığı, üst extremite kas gücü kaybı, aksiller veya lateral göğüs duvarı duyu kaybı ve lenfödem meme cerrahisi sonrası üst ekstremitede morbidite ve disabiliteye neden olan kas-iskelet sistemi problemleridir (8,(13)(14)(15)(16)(17). Literatürde meme kanseri nedeni ile opere olan ve aksiller diseksiyon uygulanan hastaların %42-82'sinde, en az bir kas-iskelet sistemi problemine rastlandığı bildirilmektedir (6,18,19,20).…”

Section: Introductionunclassified

Meme kanseri cerrahisi: üst ekstremite için bir problem midir?

...

2011

Tftr

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ÖzetAmaç: Meme kanseri nedeniyle cerrahi geçiren hastalarda, omuz ağrısı, eklem hareket açıklığı (EHA), omuz kas gücü (OKG), el kavrama gücü (el KG) ve lenfödem varlığını belirlemekti. Gereç ve Yöntem: Çalışmaya meme kanseri nedeni ile unilateral opere olan 93 kadın dahil edildi. Opere edilen tarafta omuz ağrı şiddeti (istirahat ve hareket) vizüel analog skala ile değerlendirildi. Aktif omuz EHA gonyometre ile, OKG ve el KG el dinamometresi ile ölçüldü. Lenfödem varlığı kol-önkol çevre ölçümü ile değerlendirildi. Bulgular: Hareketle omuz ağrısı (%76,3) ve el KG kaybı (%59) en sık gözlenen üst ekstremite problemleri idi. Diğer sorunlar ise sırasıyla; omuz abdüksiyon (%46,2) ve fleksiyon (%45,1) EHA kısıtlılığı, istirahat omuz ağrısı (%41,9), abdüksiyon (51,6) ve fleksiyon (%38,8) OKG kaybı, kolda (%23,7) ve önkolda (%11,9) lenfödem varlığı idi. Ayrıca, opere edilen tarafta omuz EHA, OKG ve el KG değerleri opere edilmeyen taraftan anlamlı derecede düşüktü (p<0,05). Sonuç: Meme kanseri cerrahisi sonrası azalmış omuz EHA, OKG, el KG; ağrı ve lenfödem varlığının önemli üst ekstremite kas-iskelet sistemi problemleri olması nedeniyle, bu parametreler bu hastaların rehabilitasyonunda göz önünde bulundurulmalıdır. Anahtar Kelimeler: Meme kanseri, ağrı, fonksiyon, kas gücü, lenfödem Sum maryObjective: The aim of this study was to determine shoulder pain, range of motion (ROM), shoulder muscle strength (SMS), handgrip strength (HS), and the presence of lymphedema in patients who had undergone breast cancer surgery. Materials and Methods: Ninety-three females operated unilaterally for breast cancer were included in the study. Shoulder pain intensity of the operated side (rest and movement) was evaluated by a visual analogue scale. Active shoulder ROM was measured using a goniometer, SMS and HS was measured by a hand dynamometer. The presence of lymphedema was assessed by arm-forearm circumference measurements. Results: Shoulder pain during movement (76.3%) and decreased HS (59%) were the most common upper extremity problems. Other problems were shoulder pain during rest (41.9%), limited shoulder abduction (46.2%) and flexion (45.1%), decreased SMS in abduction (51.6%) and flexion (38.8%), the presence of lymphedema in the arm (23.7%) and forearm (11.9%), respectively. Additionally, shoulder ROM, SMS, and HS in the operated side were significantly lower than in the nonoperated side (p<0.05). Conclusion: After breast cancer surgery, reduced shoulder ROM, SMS, and HS and the presence of pain and lymphedema are important upper extremity musculoskeletal problems, thus, these parameters should be considered in the rehabilitation of these patients.

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Arm morbidity after breast conservation and axillary therapy

Cited by 34 publications

References 21 publications

Pain and other symptoms during the first year after radical and conservative surgery for breast cancer

Pain and other symptoms during the first year after radical and conservative surgery for breast cancer

Comparison of humeral rotation co-activation of breast cancer population and healthy shoulders

Meme kanseri cerrahisi: üst ekstremite için bir problem midir?

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