Abstract
Purpose: The aim of the study was to evaluate posture in patients undergoing breast-conserving therapy (BCT) in relation to the type of surgical intervention to the axilla. Methods: The study was conducted on patients who had undergone breast-conserving surgical treatment for breast cancer 5–6 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. Results: No statistically significant differences were observed with respect to the parameters between the BCT+SLNB and BCT+ALND groups (p > 0.05). However, the differences were highly significant between the 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. Conclusions: Postural imbalance 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 ALND.
Highlights
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 [1,2]
The studied group consisted of 117 women, 63 of whom underwent breastconserving therapy (BCT)+sentinel lymph node biopsy (SLNB), while 54 women underwent BCT+axillary lymph node dissection (ALND)
We examined the relationship between postural imbalance in breast cancer patients undergoing BCT depending on type of axillary intervention
Summary
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 [1,2]. The type of surgical intervention to the axilla plays an important role. Depending on the initial staging of the disease, sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) may be performed. Randomized clinical trials and meta-analyses showed significantly higher rate of late complications in the case of ALND [3,4]. BCT+SLNB is not free of adverse sequelae. In patients undergoing BCT+SLNB, a limited motion range of the shoulder, lymphedema and hypoesthesia are observed [5]
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