Longitudinal change of treatment-related upper limb dysfunction and its impact on late dysfunction in breast cancer survivors: A prospective cohort study

Authors

  • Eun Joo Yang MD,

    1. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
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  • Won-Beom Park MD, MS,

    1. Department of Rehabilitation Medicine, Inchon Sarang Hospital, Korea
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  • Kwan Sik Seo MD, PhD,

    1. Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Sung-Won Kim MD, PhD,

    1. Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
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  • Chan-Yeong Heo MD, PhD,

    1. Department of Plastic Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
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  • Jae-Young Lim MD, PhD

    Corresponding author
    1. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
    • 300 Gumi-dong Bundang-gu, Seongnam-si, Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do 463-707, Republic of Korea. Fax: +82-31-787-4056.
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Abstract

Background and Objectives

To investigate the prevalence of upper limb dysfunction (ULD) and subtypes after breast cancer surgery and to identify factors associated with late ULD.

Methods

Among 191 enrolled patients, 191 were evaluated at 3 months, 187 at 6 months, and 183 at 12 months after surgery. Pain, shoulder range of motion, muscle strength, and arm circumference were assessed. Based on symptoms and physical examinations, the types of ULD common after breast cancer treatment were diagnosed and categorized.

Results

The prevalence of ULD after surgery were 24.6%, 20.9%, and 26.8% at 3, 6, and 12 months, respectively. The most common types of ULD were pectoralis tightness at 3 and 6 months and lymphedema at 12 months. Patients with pectoralis tightness or lymphedema at 3 or 6 months showed a higher prevalence of rotator cuff disease at 12 months compared with those without early pectoralis tightness or lymphedema.

Conclusions

The major post-operative ULD were pectoralis tightness at 3 and 6 months and lymphedema at 12 months. Late ULD such as rotator cuff disease were associated with pectoral tightness or lymphedema at earlier stages. Diagnosis and treatment of ULD should take place as soon as possible after surgery. J. Surg. Oncol. 2010;101:84–91. © 2009 Wiley-Liss, Inc.

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