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Hagner-Derengowska M1,2, Kałuzny K2, Hagner W2, Głowacka-Mrotek I2
1Collegium Medicum of the Nicolaus Copernicus University in Torun, Department of Neuropsychology, Bydgoszcz, Poland, 2Collegium Medicum of the Nicolaus Copernicus University in Torun, Department of Rehabilitation, Bydgoszcz, Poland
Background: Breast conserving therapy became a leading technique in surgical treatment of breast cancer. Due to high 5-year survival rates among patients undergoing breast conserving surgery, a lot of attention is focused on adverse effects of surgical and adjuvant treatment.
Purpose: The goal of this work was to assess upper limb sequelae among patients undergoing breast conserving therapy (BCT) for breast cancer after 5-6 years from surgical procedure.
Methods: A controlled clinical study was conducted on 128 patients who had undergone surgery 5-6 years prior. BCT+ALND (Axillary Lymph Node Dissection) was performed in 58 patients and 69 underwent BCT+SLND (Sentinel Lymph Node Dissection). Patients declared active participation in physiotherapy. The following parameters were assessed in studied subjects: range of motion in the shoulder joint, superficial sensation, upper limb circumference, skin sensation, and presence of winged scapula sign.
Results: After 5-6 years from BCT patients who had undergone BCT+ALND presented with significantly poorer outcomes concerning upper limb range of motion on the operated side compared to the BCT+SLND group with regard to the following features: flexion (p=0.00004), external rotation (p=0.0292), internal rotation (p=0.0448). However, no statistically significant differences were noted between compared groups with regard to upper limb circumference and sensation disturbances. Statistically significant differences between limb on the operated side (operated limb - OL) versus contralateral limb (healthy limb - HL) were noted in the BCT + SLND group with regard to the range of motion in extension (p=0.0004), external rotation (p=0.0055), and internal rotation (p 0.0001), as well as the occurrence of winged scapula sign (p 0.0001) and sensation disturbances (p 0.0001).
Conclusion(s): Functional assessment of the upper limb on the operated side versus non-operated side in the BCT+SLNB and BCT+ALND groups demonstrated that both procedures are not free of distant sequelae, although the BCT+ALND group is more frequently affected.
Implications: Our study demonstrated that both types of intervention in the axillary fossa in women, who declared participation in physiotherapy after 5-6 years from surgical procedure was associated with the risk of undesirable treatment sequelae. Comparison of those two surgical techniques, so different in terms of invasiveness, demonstrated superiority of sentinel lymph node biopsy procedure over axillary lymphadenectomy due to possible adverse effects, such as limitation to upper limb mobility.
Keywords: Breast Conserving Therapy, breast cancer, adverse effects
Funding acknowledgements: N/A
Purpose: The goal of this work was to assess upper limb sequelae among patients undergoing breast conserving therapy (BCT) for breast cancer after 5-6 years from surgical procedure.
Methods: A controlled clinical study was conducted on 128 patients who had undergone surgery 5-6 years prior. BCT+ALND (Axillary Lymph Node Dissection) was performed in 58 patients and 69 underwent BCT+SLND (Sentinel Lymph Node Dissection). Patients declared active participation in physiotherapy. The following parameters were assessed in studied subjects: range of motion in the shoulder joint, superficial sensation, upper limb circumference, skin sensation, and presence of winged scapula sign.
Results: After 5-6 years from BCT patients who had undergone BCT+ALND presented with significantly poorer outcomes concerning upper limb range of motion on the operated side compared to the BCT+SLND group with regard to the following features: flexion (p=0.00004), external rotation (p=0.0292), internal rotation (p=0.0448). However, no statistically significant differences were noted between compared groups with regard to upper limb circumference and sensation disturbances. Statistically significant differences between limb on the operated side (operated limb - OL) versus contralateral limb (healthy limb - HL) were noted in the BCT + SLND group with regard to the range of motion in extension (p=0.0004), external rotation (p=0.0055), and internal rotation (p 0.0001), as well as the occurrence of winged scapula sign (p 0.0001) and sensation disturbances (p 0.0001).
Conclusion(s): Functional assessment of the upper limb on the operated side versus non-operated side in the BCT+SLNB and BCT+ALND groups demonstrated that both procedures are not free of distant sequelae, although the BCT+ALND group is more frequently affected.
Implications: Our study demonstrated that both types of intervention in the axillary fossa in women, who declared participation in physiotherapy after 5-6 years from surgical procedure was associated with the risk of undesirable treatment sequelae. Comparison of those two surgical techniques, so different in terms of invasiveness, demonstrated superiority of sentinel lymph node biopsy procedure over axillary lymphadenectomy due to possible adverse effects, such as limitation to upper limb mobility.
Keywords: Breast Conserving Therapy, breast cancer, adverse effects
Funding acknowledgements: N/A
Topic: Oncology, HIV & palliative care
Ethics approval required: Yes
Institution: Collegium Medicum in Bydgoszcz
Ethics committee: Bioethical Committee at the Collegium Medicum in Bydgoszcz
Ethics number: KB 666/2016
All authors, affiliations and abstracts have been published as submitted.
