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Recovery of upper limb function after axillary dissection

✍ Scribed by Rik Gosselink; Lieven Rouffaer; Peter Vanhelden; Wim Piot; Thierry Troosters; Marie-Rose Christiaens


Book ID
102440007
Publisher
John Wiley and Sons
Year
2003
Tongue
English
Weight
222 KB
Volume
83
Category
Article
ISSN
0022-4790

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✦ Synopsis


Background and objectives:

After surgery for breast cancer, data on the long-term impairment of upper limb activities of daily living (adl) are scarce. the purpose of this study was to investigate the short- and long-term recovery of upper limb adl function after surgery for breast cancer.

Methods:

Seventy-six patients, who underwent either a breast-conserving procedure with axillary dissection (bcp, n = 45) or a modified radical mastectomy (mrm, n = 31), were included. the patients were assessed on the fourth postoperative day, after 3 weeks, and after 3 months. shoulder mobility, arm circumference, and upper limb adl (score from 1 to 7) were evaluated.

Results:

In the early postoperative phase, a considerable decrease in shoulder mobility and the ability to perform upper limb adl were observed. after 3 months, mrm patients had more limitations in shoulder mobility than bcp patients (shoulder flexion: 150 degrees vs. 126 degrees, respectively, p = 0.0001). in addition, upper limb adl was still significantly impaired: mrm patients suffered from greater functional disabilities than bcp patients, adl score 2.7 and 1.8, respectively (p = 0.037). patients with axillary radiation experienced greater disability of shoulder mobility and adl.

Conclusions:

Three months after surgery for breast cancer, impaired shoulder mobility, and adl persisted in a substantial number of patients. type of surgery and axillary irradiation contributed significantly to upper limb recovery. this observation warrants considering continuation of physiotherapy aiming to improve restoration of upper limb function.


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## Abstract ## BACKGROUND The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment‐related upper‐limb morbidity. In the current prospective study, short‐term upper‐limb morbidity was ass