Hojan Katarzyna, Wojtysiak Magdalena, Huber Juliusz, Molińska-Glura Marta, Wiertel-Krawczuk Agnieszka, Milecki Piotr
Department of Rehabilitation, Greater Poland Cancer Centre, 15 Garbary St., 61-866, Poznan, Poland.
Department of Pathophysiology of Locomotor Organs, Karol Marcinkowski University of Medical Science, 28 Czerwca 1956 St. No 135/147, 61-545 Poznan, Poland.
Eur J Oncol Nurs. 2016 Aug;23:8-14. doi: 10.1016/j.ejon.2016.03.007. Epub 2016 May 4.
Breast cancer surgery or radiotherapy (RT) are potential causes of persistent pain syndrome. It remains to be clarified whether numbness or pain reported by patients after mastectomy and RT are conditioned by changes in nerve transmission. The aim of this study was to examine the potential relationship between subjective sensory complications and neurophysiological examinations in breast cancer survivors with post-mastectomy pain syndrome.
Sixty breast cancer survivors (30 patients only after mastectomy - group A; and 30 after mastectomy with RT - group B) complaining of pain and sensory disturbances in the brachial plexus area and 20 healthy women (group C) were studied with regard to sensory perception and pain intensity using the Visual Analogue Scale and electroneurography (ENG).
There was a statistically significant decrease in the amplitudes in SCV recordings following stimulation of the ulnar (p = 0.04) and lateral cutaneous antebrachii nerves (p = 0.02) in group B in comparison to group C. Additionally, a significant decrease in the amplitude and conduction velocity parameters was detected in the sensory fibers of the median and medial cutaneous antebrachii nerves in group A (p = 0.00 and p = 0.02, respectively) in comparison to group C.
The results of this pilot study suggest persistent post-mastectomy pain syndrome sometimes appears as a result of nerve injury in course of breast cancer surgery and RT. Therefore studies in nerve conduction may be added to the comprehensive patient assessment used in planning breast cancer patients' rehabilitation after oncological treatment has finished.
乳腺癌手术或放疗是持续性疼痛综合征的潜在病因。乳房切除术后及放疗后患者报告的麻木或疼痛是否受神经传导变化影响仍有待阐明。本研究旨在探讨乳腺癌幸存者乳房切除术后疼痛综合征主观感觉并发症与神经生理学检查之间的潜在关系。
对60例乳腺癌幸存者（30例仅行乳房切除术——A组；30例行乳房切除术后放疗——B组），她们主诉臂丛神经区域疼痛和感觉障碍，以及20名健康女性（C组），使用视觉模拟量表和神经电图（ENG）研究其感觉知觉和疼痛强度。
与C组相比，B组在刺激尺神经（p = 0.04）和前臂外侧皮神经（p = 0.02）后，感觉神经传导速度（SCV）记录的波幅有统计学显著降低。此外，与C组相比，A组正中神经和前臂内侧皮神经感觉纤维的波幅和传导速度参数有显著降低（分别为p = 0.00和p = 0.02）。
这项初步研究结果表明，持续性乳房切除术后疼痛综合征有时是乳腺癌手术和放疗过程中神经损伤的结果。因此，在肿瘤治疗结束后规划乳腺癌患者康复时，神经传导研究可纳入综合患者评估中。
