Article

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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
- Cancer du sein

Langue : ANGLAIS