Comparison of Shoulder-Arm Complex Pain,Function, and Scapular Dyskinesia in Women With and Without Unilateral Lymphedema After Breast Cancer Surgery |
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| Authors: | Tugce Sirin Korucu Sevtap Gunay Ucurum Engin Tastaban Hedef Ozgun Derya Ozer Kaya |
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| Institution: | 1. Izmir Katip Celebi University, Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Turkey;2. Izmir Katip Celebi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Turkey;3. Department of Physical Medicine and Rehabilitation, Adnan Menderes University Medical Faculty, Aydin, Turkey;4. Department of General Surgery, Adnan Menderes University Medical Faculty, Aydin, Turkey;1. Department of Surgical Oncology, Breast Disease Management Group, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India;2. Breast Disease Management Group, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India;3. Department of Pathology, Breast Disease Management Group, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India;4. Department of Radiation Oncology, Breast Disease Management Group, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India;1. Department of Radiation Oncology, UPMC Hillman Cancer Center and University of Pittsburgh School of Medicine, Pittsburgh, PA;2. Clinical and Translational Science and Center for Research on Healthcare, University of Pittsburgh School of Medicine, Pittsburgh, PA;1. Magee-Womens Research Institute, Pittsburgh, PA;2. Integrative Systems Biology Program, University of Pittsburgh, Pittsburgh, PA;3. UPMC Department of Surgery, Pittsburgh, PA;4. Department of General Surgery, Selçuk University, Konya, Turkey;5. Department of Pathology, Selçuk University, Konya, Turkey;6. Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA;7. Women’s Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, PA;8. UPMC Hillman Cancer Center, Pittsburgh, PA;9. Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA;10. Institute for Precision Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, PA;1. Department of Medicine and Surgery and Translational Medicine, “Sapienza” University of Rome, Radiotherapy Oncology, St Andrea Hospital, Rome, Italy;2. Department of Statistical Sciences, “Sapienza” University of Rome, Rome, Italy;3. Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Hearth Failure Unit, St Andrea Hospital, Rome, Italy;4. Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, St Andrea Hospital, Rome, Italy;1. Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Shenzhen Center, Shenzhen, China;1. Department of Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan;2. Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan;3. Division of General Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan |
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| Abstract: | IntroductionLymphedema is the most important complication seen after breast cancer surgery. The study aimed to evaluate pain, shoulder-arm complex function, and scapular function in women who developed lymphedema after breast cancer surgery and to compare these with women without lymphedema.Materials and MethodsFifty women with lymphedema (age, 54.34 ± 9.08 years; body mass index, 30.10 ± 4.03 kg/cm2) and 57 women without lymphedema (age, 53.68 ± 9.41 years; body mass index, 29.0 ± 5.44 kg/cm2) after unilateral surgery for breast cancer were included. Clinical and demographic information was noted. The severity of lymphedema with perimeter measurements (Frustum model), level of heaviness discomfort sensation with a visual analog scale, pain threshold with a digital algometer, shoulder-arm complex functionality with the Disabilities of the Arm, Shoulder, Hand Problems Survey (DASH), and scapular function with observational scapular dyskinesia and lateral scapular sliding tests were assessed. The t test, χ2 test, and Mann-Whitney U test were used for analyses.ResultsThe follow-up duration after the surgery was 4.24 ± 2.97 years and 3.19 ± 1.76 years, and the upper extremity volume was 2106.65 ± 510.82 cm3 and 1725.92 ± 342.49 cm³ in the lymphedema group and in the no-lymphedema group, respectively. In the lymphedema group, arm-heaviness discomfort, pain threshold levels in the trapezius and deltoid muscles, and DASH scores were worse (P < .05). The rate of scapular dyskinesia (70.0%) and type 2 scapula (32%) in the surgical side was higher in patients with lymphedema.ConclusionThe pain pressure threshold in the trapezius and deltoid muscles, heaviness sensation level, and inadequate upper extremity function are significantly higher in patients with lymphedema, and the scapular dyskinesia rate was higher. |
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| Keywords: | Mastectomy Scapula Shoulder pain |
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