Factors associated with upper limb dysfunction in breast cancer survivors

Support Care Cancer. 2021 Apr;29(4):1933-1940. doi: 10.1007/s00520-020-05668-7. Epub 2020 Aug 17.

Abstract

Objective: To analyze factors associated with upper limb dysfunction in women after breast cancer treatment.

Methodology: A cross-sectional study with 233 women over 18 years of age diagnosed with breast cancer and undergoing at least one cancer treatment (surgery and/or adjuvant treatment). Sociodemographic, anthropometric, and cancer treatment data were collected, as well as current physical and functional complications. Changes in breast tenderness and intercostobrachial nerve pathway, winged scapula, pain, cicatricial adherence, and lymphedema were evaluated by physical examination (inspection and palpation). Upper limb dysfunction was assessed using the DASH questionnaire. Chi-square test and logistic regression were used to verify possible associations between upper limb dysfunction and other variables.

Results: The results showed that 55.4% of women had some level of upper limb dysfunction. Evaluating treatment conditions, lymphadenectomy, lymphedema, presence of pain, and intercostobrachial nerve injury were associated with some level of upper limb dysfunction in the crude analysis. The adjusted analysis showed that only upper limb dysfunction remained associated with intercostobrachial nerve injury, regardless of age and body mass index.

Conclusion: Upper limb dysfunction is frequent after breast cancer treatment and may be associated with neuropathies due to changes in the intercostobrachial nerve pathway.

Keywords: Breast neoplasms; Disability; Survivors; Upper extremity.

MeSH terms

  • Breast Neoplasms / complications*
  • Breast Neoplasms / mortality*
  • Cancer Survivors / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Middle Aged
  • Quality of Life / psychology*
  • Upper Extremity / physiopathology*