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Glowacka-Mrotek I1, Kozak D1, Hagner W2, Zegarski W3
1Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Department of Rehabilitation, Bydgoszcz, Poland, 2Nicolaus Copernicus University, Collegium Medicum, Department of Rehabilitation, Bydgoszcz, Poland, 3Nicolaus Copernicus University, Collegium Medicum, Department of Surgical Oncology, Bydgoszcz, Poland
Background: In oncology, efforts are made to minimize adverse sequelae while maintaining oncological radicality, and in spite of that, late complications are still observed in breast cancer patients subjected to Breast Conserving Therapy.
Purpose: The aim of the study is to evaluate posture in patients undergoing breast conserving therapy (BCT) in relation to the type of surgical intervention to the axilla.
Methods: A case-control study was conducted on patients who formerly underwent breast conserving surgery 5 years earlier. In 54 patients, BCT+ALND (axillary lymph node dissection) was performed, while 63 patients were subjected to BCT+SLND (sentinel lymph node dissection). The control group consisted of 54 females. The study was conducted using digital postural assessment. Parameters characterizing the following structures were investigated: spinal curvature, shoulder level, inferior angles of scapulae, posterior superior iliac spines.
Results: No statistically significant differences were observed with respect to the parameters between BCT+SLNB and BCT+ALND groups (p>0.05). However, the differences were highly significant between CG (control group) and the studied groups (BCT+ALND, BCT+SLNB) for the following parameters: BETA angle of thoracolumbar spine inclination (p=0.002), GAMMA angle of thoracic spine inclination (p=0.0044), TKA (thoracic kyphosis angle) (p 0.0001) and shoulder level inclination (p=0.0004). The BCT+ALND patients were characterized by higher dependency of raised shoulder (p=0.0028) and inferior angle of the scapula (p=0.00018) on the operated side compared to BCT+SLNB patients.
Conclusion(s): Postural imbalance in breast cancer patients undergoing BCT occurs independent of the type of axillary intervention. Disturbances within the upper torso (abnormal position of shoulders and inferior angles of scapulae) are more pronounced in patients after axillary lymphadenectomy.
Implications: In our study, we demonstrated a lack of any statistically significant impact of type of axillary intervention (ALND vs. SLNB) on postural imbalance in breast cancer patients subjected to breast conserving therapy (BCT). Our study showed that body posture in BCT patients was different from that of healthy women. It was manifested by deepened thoracic kyphosis, unequal shoulder levels, scapula protrusion. The abnormalities were more pronounced in patients after axillary lymphadenectomy.
Another conclusion is that rehabilitation of breast cancer patients should include not only standard procedures increasing shoulder mobility, lymphedema reduction and scar mobilization, but also static torso and balance exercises.
Keywords: breast cancer, axillary lymph node dissection, sentinel lymph node dissection
Funding acknowledgements: Not applicable
Purpose: The aim of the study is to evaluate posture in patients undergoing breast conserving therapy (BCT) in relation to the type of surgical intervention to the axilla.
Methods: A case-control study was conducted on patients who formerly underwent breast conserving surgery 5 years earlier. In 54 patients, BCT+ALND (axillary lymph node dissection) was performed, while 63 patients were subjected to BCT+SLND (sentinel lymph node dissection). The control group consisted of 54 females. The study was conducted using digital postural assessment. Parameters characterizing the following structures were investigated: spinal curvature, shoulder level, inferior angles of scapulae, posterior superior iliac spines.
Results: No statistically significant differences were observed with respect to the parameters between BCT+SLNB and BCT+ALND groups (p>0.05). However, the differences were highly significant between CG (control group) and the studied groups (BCT+ALND, BCT+SLNB) for the following parameters: BETA angle of thoracolumbar spine inclination (p=0.002), GAMMA angle of thoracic spine inclination (p=0.0044), TKA (thoracic kyphosis angle) (p 0.0001) and shoulder level inclination (p=0.0004). The BCT+ALND patients were characterized by higher dependency of raised shoulder (p=0.0028) and inferior angle of the scapula (p=0.00018) on the operated side compared to BCT+SLNB patients.
Conclusion(s): Postural imbalance in breast cancer patients undergoing BCT occurs independent of the type of axillary intervention. Disturbances within the upper torso (abnormal position of shoulders and inferior angles of scapulae) are more pronounced in patients after axillary lymphadenectomy.
Implications: In our study, we demonstrated a lack of any statistically significant impact of type of axillary intervention (ALND vs. SLNB) on postural imbalance in breast cancer patients subjected to breast conserving therapy (BCT). Our study showed that body posture in BCT patients was different from that of healthy women. It was manifested by deepened thoracic kyphosis, unequal shoulder levels, scapula protrusion. The abnormalities were more pronounced in patients after axillary lymphadenectomy.
Another conclusion is that rehabilitation of breast cancer patients should include not only standard procedures increasing shoulder mobility, lymphedema reduction and scar mobilization, but also static torso and balance exercises.
Keywords: breast cancer, axillary lymph node dissection, sentinel lymph node dissection
Funding acknowledgements: Not applicable
Topic: Oncology, HIV & palliative care
Ethics approval required: Yes
Institution: Nicolaus Copernicus University in Torun, Poland
Ethics committee: Bioethics Committee of Collegium Medicum in Bydgoszcz
Ethics number: KB 8/2018
All authors, affiliations and abstracts have been published as submitted.
