Physiotherapy Postgraduate Program, Health and Sports Science Center, Santa Catarina State University (UDESC), Pascoal Simone, 358, Coqueiros, Florianópolis, SC, 88080-350, Brazil.
Human Movement Sciences Postgraduate Program, Health and Sports Science Center, Santa Catarina State University (UDESC), Florianópolis, Brazil.
Support Care Cancer. 2021 Apr;29(4):1933-1940. doi: 10.1007/s00520-020-05668-7. Epub 2020 Aug 17.
To analyze factors associated with upper limb dysfunction in women after breast cancer treatment.
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.
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.
Upper limb dysfunction is frequent after breast cancer treatment and may be associated with neuropathies due to changes in the intercostobrachial nerve pathway.
分析乳腺癌治疗后女性上肢功能障碍的相关因素。
这是一项横断面研究，共纳入 233 名年龄在 18 岁及以上、被诊断患有乳腺癌并至少接受过一次癌症治疗（手术和/或辅助治疗）的女性。收集了社会人口统计学、人体测量学和癌症治疗数据，以及当前的身体和功能并发症。通过体格检查（视诊和触诊）评估乳房触痛和肋间臂神经通路、翼状肩、疼痛、瘢痕粘连和淋巴水肿的变化。上肢功能障碍采用 DASH 问卷进行评估。卡方检验和逻辑回归用于验证上肢功能障碍与其他变量之间的可能关联。
结果显示，55.4%的女性存在不同程度的上肢功能障碍。在粗分析中，评估治疗情况、淋巴结清扫术、淋巴水肿、疼痛存在和肋间臂神经损伤与上肢功能障碍的一定程度相关。调整分析显示，只有上肢功能障碍与肋间臂神经损伤相关，与年龄和体重指数无关。
乳腺癌治疗后上肢功能障碍很常见，可能与肋间臂神经通路改变引起的神经病变有关。
