Abstract
BackgroundMany patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to investigate the efficacy of physiotherapy treatment of shoulder function, pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection.MethodsThirty patients following breast cancer surgery and axillary lymph node dissection were included in a randomised controlled study. Assessments were made at baseline and after three and six months. The treatment group received standardised physiotherapy treatment of advice and exercises for the arm and shoulder for three months; the control group received a leaflet containing advice and exercises. If necessary soft tissue massage to the surgical scar was applied. Primary outcome variables were amount of pain in the shoulder/arm recorded on the Visual Analogue Scale, and shoulder mobility (flexion, abduction) measured using a digital inclinometer under standardized conditions.Secondary outcome measures were shoulder disabilities during daily activities, edema, grip strength of both hands and quality of life. The researcher was blinded to treatment allocation.ResultsAll thirty patients completed the trial. After three and six months the treatment group showed a significant improvement in shoulder mobility and had significantly less pain than the control group. Quality of life improved significantly, however, handgrip strength and arm volume did not alter significantly.ConclusionPhysiotherapy reduces pain and improves shoulder function and quality of life following axillary dissection after breast cancer.Trial registrationISRCTN31186536
Highlights
Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection
Thirty-six women with breast cancer surgery and axillary lymph node dissection (ALND) were operated during the trial
Six patients did not give informed consent as they were convinced that they needed physiotherapy and did not want to take the risk to be placed in the control group
Summary
Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. The purpose of this study is to investigate the efficacy of physiotherapy treatment of shoulder function, pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection. Following surgery with ALND, 73% of women reported restricted shoulder mobility, tightness, edema, pain, numbness of the arm, and limitations in daily life [2,3]. These complaints could be due to tissue and nerve damage. An investigation of recovery of upper limb function after ALND in 76 women by Gosselink et al showed that three months following surgery, upper limb function is still impaired in a significant number (27%) of patients [7]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have