Nerve entrapments associated with postmastectomy lymphedema

Abstract

Ninety females underwent mastectomy for breast cancer and were thereafter investigated to determine whether nerve entrapments were responsible for some of the disabling symptoms in their arms. The majority of these patients suffered from fullness (edema), numbness, paraesthesia, weakness and pain of the arm on the mastecotmized side. Lymphedema of varying degrees found in 50% of these patients was associated with brachial plexus entrapment and carpal tunnel syndrome (CTS). 28% of the patients has CTS, and 28% suffered from brachial plexus entrapment of the arm on the mastecotmized side, as compared with 8% and 5%, respectively, on the nonoperated side. 12% of the patients suffered from both types of entrapment. Thus we consider that brachial plexus entrapment and carpal tunnel syndrome should be added to the list of complications following mastectomy, with lymphedema playing an active part in their development.

Safety of Elective Hand Surgery Following Axillary Lymph Node Dissection for Breast Cancer

“…Lymphedema when occurs is commonly associated with chronic pain, arm deformity, and cellulites which may significantly lower patients’ function and quality of life. Moreover, it has been shown in one study that nearly 20% of patients developed carpel tunnel syndrome following ALND (10). Thus, it is not rare to encounter such patients with different hand conditions that require elective surgery, but yet, despite the clear indication for surgery, most of these patients are never operated.…”

The Patient with Lymphatic System Disorder—Preferred Practice Pattern 6H

“…97,98 In this case, the patient developed symptoms consistent with moderately severe carpal tunnel syndrome 12 years after the onset of lymphedema. This patient has been seen for two separate episodes since her initial visit, the first in association with carpal tunnel release surgery and the second following an infection of unknown origin in the olecranon bursa.…”

Effective treatment of the brachial plexus syndrome in breast cancer patients by early detection and control of loco-regional metastases with radiation or systemic therapy

“…19 Almost all of these patients had local metastases, but only 9 had been previously irradiated. We have not found that arm edema alone, however severe, causes the BPS; the 28 patients we have followed for years with severe arm edema unrelated to locoregional recurrence retained the ability to abduct their arms to 180° (Braverman AS, unpublished data).…”