Changes in shoulder muscle size and activity following treatment for breast cancer

Abstract

Muscles affected in the long term are the muscles associated with pain and disability yet are not in the direct field of surgery or radiotherapy. Primary muscle shortening and secondary loss of muscle activity may be producing a movement disorder similar to the 'Dropped Shoulder Syndrome'. Exercise programmes should aim not only for range of movement but also for posture correction and education of potential long-term effects.

Computer Simulation of Pectoralis Major Muscle Strain to Guide Exercise Protocols for Patients After Breast Cancer Surgery

“…16,21,44,45 Surgical trauma to this muscle may include removal of the anterior fascia required for the cancer extirpation, 45 tacking the skin onto the muscle to prevent seroma formation, 2 dissection of the muscle and underlying rib to provide access to blood vessels for vascularizing a surgical flap, 6,29 elevation of the muscle to create a pocket with subsequent expansion to receive a breast implant, 50 or a full release of part of the attachment of the muscle to prevent upward migration of a breast implant and to facilitate expansion of the lower pole of the reconstructed breast. 42 Radiation therapy may also adversely affect the PM muscle.…”

“…According to magnetic resonance imaging (MRI) and electromyographic (EMG) recordings, the PM muscle decreases in size and function after surgery, 44 and the direction of motion restriction suggests PM tightness. 33 Loss of flexibility of the muscle suggests the need to start stretching exercises as early as possible; however, exercise programs that start in the first days after surgery have been associated with an increased risk of seroma formation.…”

Fisioterapia Na Flexibilidade Do Ombro Pós Cirurgia De Câncer De Mama: Revisão Sistemática

“…(3)(4)(5)(6)(7)(8) A limitação da ADM do ombro homolateral à cirurgia representa uma das principais complicações pós-operatórias do tratamento do câncer de mama, sendo os movimentos de abdução e flexão do ombro os mais afetados. (9) A hipomobilidade do membro, provocada pela imobilização prolongada, por medo de sentir dor ou ocorrer deiscência da cirurgia, assim como o tipo de cirurgia, o tamanho da incisão, realização de linfonodectomia axilar e traumatismos no nervo torácico longo, levam a esta limitação. (8,10) A redução da ADM provoca impacto negativo na funcionalidade dos indivíduos acometidos.…”

Application of a domicile-based exercise program for shoulder rehabilitation after breast cancer surgery

“…The limitation of the range of motion (ROM) of the shoulder is considered one of the major postoperative complications of the treatment of breast cancer, and is accompanied by impairment and decrease of the upper limb function (2)(3)(4)(5)(6)(7) . The shoulder is subject to the rapid installation of stiffness and muscle atrophy after breast cancer surgery, with the flexion and abduction movements the most affected (7)(8) . The prolonged immobilization caused by fear and/or pain, as well as the type of surgery, the incision size, the performance of axillary lymphadenectomy, long thoracic nerve trauma or muscle spasm throughout the cervical region, arising from the muscular defense reaction, are factors that cause women to have a tendency toward little movement of the upper limb (9)(10) .…”