Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Upper-Limb Morbidity in Patients Undergoing a Rehabilitation Program After Breast Cancer Surgery

A 10-Year Follow-up Study

de Carlos-Iriarte, Esperanza, PhD1; Mosquera-González, Margarita, PhD, MPH2; Alonso-García, Marcos, MPH3; Andrés-Prado, María José, PhD, MPH4; Machota-Blas, Elizabeth, MD5; Hernández-García, José Manuel, PhD6; Rodríguez-Caravaca, Gil, PhD, MPH7

doi: 10.1097/01.REO.0000000000000131
RESEARCH REPORT: PDF Only

Objective: To identify long-term predictive factors for upper-limb morbidity in patients who completed an early rehabilitation program after breast cancer surgery.

Material and Methods: Prospective cohort study. The study population comprised 659 female patients who were consecutively enrolled in a rehabilitation program shortly after breast cancer surgery between April 1999 and June 2010. The rehabilitation program comprised clinical evaluation, written information on hygiene measures, aerobic exercise, and physical therapy. Variables assessed for affected and contralateral limb included circumferential measurement for lymphedema, passive range of motion in the shoulder, pain intensity using a visual analog scale, and sensory loss by the pin-prick method and tactile sensitivity. Predictive variables covered age, body mass index, regular physical activity, previous shoulder pathology, type of breast surgery, side of surgery, postsurgical complications, sentinel lymph node biopsy/axillary lymph node dissection, tumor size and histology, chemotherapy, radiotherapy, and hormonal treatment. A multivariate logistic regression analysis was performed to control for confounding factors.

Results: The mean follow-up period was 72 months. A total of 306 patients (64.4%) showed upper-limb symptoms at some point during the follow-up period. Sensory loss and pain were the most relevant impairments. Predictive factors for shoulder and arm morbidity were obesity (odds ratio [OR] = 2.45; 95% confidence interval [CI], 1.18-5.08), previous shoulder pathology (OR = 6.05; 95% CI, 2.89-12.63), postsurgical complications (OR = 2.16; 95% CI, 1.05-4.43), and regional lymph node radiotherapy (OR = 3.42; 95% CI, 2.07-5.63).

Conclusions: Previous shoulder pathology, postsurgical events, obesity, and site of radiotherapy were significant risk factors for developing shoulder and arm morbidity.

1Head of Department, Service of Rehabilitation Medicine, University Hospital “12 de Octubre,” Madrid, Spain

2Consultant, Preventive Medicine Unit, University Hospital Fundación Alcorcón, Madrid, Spain

3Resident, Preventive Medicine Unit, University Hospital Fundación Alcorcón, Madrid, Spain

4Consultant, Preventive Medicine Unit, University Hospital Fundación Alcorcón, Madrid, Spain

5Consultant, Service of Rehabilitation Medicine, University Hospital “12 de Octubre,” Madrid, Spain

6Consultant, Service of Obstetrics and Gynaecology, University Hospital “12 de Octubre,” Madrid, Spain

7Consultant, Preventive Medicine Unit, University Hospital Fundación Alcorcón, Madrid, Spain

Correspondence: Margarita Mosquera-González, PhD, MPH, Preventive Medicine Unit, University Hospital Fundación Alcorcón, C/Budapest 1, 28922, Alcorcón, Madrid, Spain (mmosquera@fhalcorcon.es).

The authors declare no conflicts of interest.

Copyright 2018 © Oncology Section, APTA
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website