This study aimed to investigate the risk factors of the AWS in patients who underwent
breast cancer surgery.
Our study included 56 patients, who attended physiotherapy after breast cancer surgery. The patients were divided into AWS and non-AWS groups according to their diagnosis. AWS were diagnosed by physical therapist assessment such as palpable cord of tissue and limited flexion and abduction movement of shoulder. Non-AWS group included patient who is diagnosed as a lymph edema or neuropathic pain. Cut-off value were determined based on ROC analysis. The chi-square test is used to evaluate the association between clinical characteristics and AWS. Uni-variate and multivariate logistic regression analyses were performed to assess the predictive factors of the AWS. A p-value of less than 0.05 was considered statistically significant. Statistical analysis were performed using SPSS-22.
Our result indicated that patient aged younger than 53 years old more likely to develop the AWS compared with older than 53 years old (p = 0.012). Similarly, body mass index (BMI) less than 27 patients significantly likelihood of developing AWS than BMI higher than 27 (p = 0.021). Days after surgery was also the significant factor, less than 55 days after surgery tend to develop AWS (p 0.001). In addition, higher pain score (>8) strongly associated with AWS (p 0.001). By uni-variate analysis, younger age (OR: 0.92, 95% CI: 0.86-0.99, p = 0.037), starting physical therapy earlier (OR: 0.99, 95% CI: 0.98-1.00, p = 0.012), and higher pain scores (OR: 1.6, 95% CI: 1.22-2.09, p 0.001) were significant predictors of AWS. Multivariate analyses were showed age (OR: 0.90, 95% CI: 0.81-0.99, p = 0.046), days after surgery (OR: 0.99, 95% CI: 0.98-1.00, p = 0.011), and pain score (OR: 1.22, 95% CI: 1.22-2.72, p = 0.003) remained significant predictor.
Younger age, starting physical therapy earlier, and higher pain scores are significant predictors of AWS in both uni-variate and multivariate logistic regression models.
Clinical management strategies for AWS should consider patient age, the timing of physical therapy initiation, and pain levels as important factors for risk assessment.
physiotherapy
breast surgery
