Abstract
PurposeTo evaluate the pathological effect of the duration of arm swelling on the shoulder pathology in patients with breast cancer-related lymphedema.MethodsForty seven breast cancer patients with unilateral arm lymphedema were assessed. The duration of the arm swelling and shoulder pain were recorded. Ultrasound examination of the shoulder joint was performed in all patients to detect any lesions.ResultsAbnormalities were detected by ultrasound in 41/47 (87.2%) study participants. Subacromial subdeltoid bursal thickening was found in 26/47 (55.3%) participants, distension of the biceps brachii tendon sheath was found in 14/47 (29.8%) and a supraspinatus tendon tear was found in 13/47 (27.7%). Patients with a supraspinatus tendon tear were found to have a significantly longer duration of lymphedema (1310 days vs. 398 days, p = 0.032).ConclusionsThe duration of arm lymphedema has a progressive pathological effect on rotator cuff. Clinicians should adopt an early management approach of shoulder pain in patients with breast cancer-related lymphedema.
Highlights
Breast cancer-related lymphedema (BCRL) and shoulder pain are common problems and are considered as the quality of life (QOL) predictors in breast cancer patients after surgery [1].PLOS ONE | DOI:10.1371/journal.pone.0142950 November 16, 2015Shoulder Pathology and Lymphedema DurationBCRL can cause or aggravate shoulder pain by decreasing the range of motion in the affected limb, increasing the fluid tension in the subcutaneous tissue, increasing the risk of cellulitis and other infections, increasing the risk of lymphangiosarcoma, decreasing the healing capacity in the affected tissue, and causing pathological effects on the rotator cuff tendon [2, 3]
The aim of our present study was to assess the pathological effect of the duration of lymphedema on the shoulder pathology in patients with BCRL by using ultrasound
Four patients were at stage 3 as per the International society of Lymphology lymphedema staging system, and 43 patients were at stage 2
Summary
Breast cancer-related lymphedema (BCRL) and shoulder pain are common problems and are considered as the quality of life (QOL) predictors in breast cancer patients after surgery [1].PLOS ONE | DOI:10.1371/journal.pone.0142950 November 16, 2015Shoulder Pathology and Lymphedema DurationBCRL can cause or aggravate shoulder pain by decreasing the range of motion in the affected limb, increasing the fluid tension in the subcutaneous tissue, increasing the risk of cellulitis and other infections, increasing the risk of lymphangiosarcoma, decreasing the healing capacity in the affected tissue, and causing pathological effects on the rotator cuff tendon [2, 3]. Breast cancer-related lymphedema (BCRL) and shoulder pain are common problems and are considered as the quality of life (QOL) predictors in breast cancer patients after surgery [1]. Breast cancer patients may experience a reduced QOL and a prolonged hospital stay because of these complications [3, 4]. An accurate diagnosis and proper management of shoulder pain are necessary for reducing the risk of disability and improving the QOL in patients with BCRL. The pathology of the shoulder pain related to BCRL has not yet been fully identified. BCRL is a chronic condition and the duration of the lymphedema may have an impact on the nature of the shoulder pathology
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