Abstract
Radiotherapy (RT) is an effective treatment for managing breast cancer patients with breast conserving surgery, but patients may experience radiation-induced shoulder problems. Even though the course of shoulder morbidity is unknown, pectoral muscle changes after radiotherapy can be a major cause of shoulder problems. Twenty-two patients treated with RT for unilateral breast cancer were included in the study. All patients underwent serial computed tomography (CT) imaging before and immediately after RT, as well as 2 months, 6 months, 2 years, and 3–4 years after RT. These CT scans were used to compare muscle volume changes. The pectoral muscle volume and muscle volume surrounding the scapular measurement was performed using 3D modelling after segmentation of the CT scans. In all patients, the pectoral muscle volume increased during the 2 months after RT, and there was continuous volume reduction from 2–48 months after RT. Changes in muscle volume ratio over time were analysed by repeated measure ANOVA and it was found that there was a significant change in the pectoral muscle volume (p < 0.001) from Just before RT and Immediately after RT at 2 month after RT. On the other hand, the changes in the muscle volume of the surrounding scapular were not significant.
Highlights
The recent introduction of new surgical approaches, such as sentinel lymph node biopsy (SLNB), and a reduction of RT to the axilla are expected to result in a decrease, but not the complete elimination, of shoulder morbidity among breast cancer patients[8,9,10,11,12,13]
Previous studies did not exclude the adverse effects of RT on the axillary site, which may play an important role in shoulder morbidity
Using 3D modelling based on computed tomography (CT) imaging after RT, we examined the effects of radiation therapy, commonly used in breast cancer patients, on muscles through a timely change in pectoral muscles volume
Summary
The recent introduction of new surgical approaches, such as sentinel lymph node biopsy (SLNB), and a reduction of RT to the axilla are expected to result in a decrease, but not the complete elimination, of shoulder morbidity among breast cancer patients[8,9,10,11,12,13]. Johansen et al.[14] recently evaluated impaired shoulder motion after RT and surgery for breast cancer. They stated that damage to the pectoralis major muscle was the most important factor in the development of this complication. Exclusion criteria (1) No radiotherapy (2) Radiotherapy to axillary (3) BCS with ALND (4) Mastectomy (5) Reconstructive surgery (6) Current or previous history of shoulder problem problems in breast cancer patients. Hidding et al.[21] found level 1 evidence for axillary lymph node dissection [ALND], and concurrent radiotherapy and chemotherapy as risk factors for reduced muscle strength. The extent to which factors such as surgery, radiotherapy and patient characteristics affect of limited shoulder motion and shoulder pain is not well documented
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
