Abstract
Objectives
To assess the changes in shoulder strength of patients with breast cancer during the
first year after surgery; and to compare the effect of sentinel lymph node biopsy
(SLNB) and axillary lymph node dissection (ALND) on shoulder strength.
Design
Prospective longitudinal observational study from presurgery to 1 year after.
Setting
Tertiary hospital.
Participants
Of 129 consecutive patients examined for eligibility, a sample of women (N=112) with
breast cancer were included (44 underwent ALND, and 68 underwent SLNB).
Interventions
Not applicable.
Main Outcomes Measures
Difference between the affected and unaffected arm in strength of shoulder external
rotators, internal rotators, abductors, and serratus anterior, measured by dynamometry.
Evaluations were performed prior to surgery and at 1, 6, and 12 months after surgery.
Results
After breast cancer ALND surgery, strength decreased significantly at the first month
for internal rotators, without having recovered presurgery values after 1 year of
follow-up, with a mean difference of 2.26kg (P=.011). There was no significant loss of strength for patients treated with SLNB.
The loss of shoulder range of motion was only significant the first month for the
ALND group. The factors identified as associated with strength loss in the general
estimating equation models were the ALND surgery and having received physical/occupational
therapy during follow-up.
Conclusions
One year after breast cancer surgery, patients treated with ALND had not recovered
their previous shoulder internal rotators strength, whereas those who underwent SLNB
presented no significant loss of strength. This provides important information for
designing rehabilitation programs targeted specifically at the affected muscle group
after nodal surgical approach.
Keywords
List of abbreviations:
ALND (axillary lymph node dissection), OT (occupational therapy), PT (physical therapy), SLNB (sentinel lymph node biopsy)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: January 04, 2016
Footnotes
Supported by the Instituto de Salud Carlos III Fondo Europeo de Desarrollo Regional (grant no. PI06/90070).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
