Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, Maharashtra, India.
Department of Obstetrics and Gynaecology,Krishna Institute of Medical Sciences Deemed to Be University, Karad, Maharashtra, India.
Asian Pac J Cancer Prev. 2022 Oct 1;23(10):3355-3360. doi: 10.31557/APJCP.2022.23.10.3355.
Lymphedema in breast cancer survivors is a very common condition which progressively may lead to entrapment neuropathy. In lymphedema there is accumulation of fluid due to removal of lymph nodes which causes stretching of nerve fibres within the skin, compression on top of the nerve bundle leading to nerve entrapment. This will increase the neural mechanosensitivity and functional impairment of shoulder as a protective neural response to movement or traction.
This study was carried out by assessing the total 72 breast cancer survivor women, with lymphedema. Out of 72, 28 of women underwent lumpectomy, 12 underwent quadrantectomy and 32 underwent unilateral mastectomy. These subjects were assessed for neural tissue mobility by taking pain assessment using visual analogue scale (VAS), range of motion (ROM) using goniometer, lymphedema measurement using an inch tape. The neural tissue mobility for median nerve, ulnar nerve and radial nerve was measured using limb tension test.
The result obtained from this study showed that neural tissue mobility was significantly impaired in breast cancer survivors with lymphedema. The result of the upper limb tension tests showed 32 women with mild lymphedema had median nerve affected on the involved side 54.1%, about 21 women had moderate lymphedema with 75% of women had median and 25% ulnar nerve affected with median nerve affected in majority of women. Only 19 women with severe lymphedema had all the three nerves affected.
This study of women who have undergone surgical intervention for breast cancer concludes that there was significant amount of neural tissue impairment noted to mechanical provocation test post operatively after 6 months of surgery. The study suggests that severity of lymphedema was directly related to the nerves affected due to neural tissue impairment.
乳腺癌幸存者中的淋巴水肿是一种非常常见的疾病，可能会逐渐导致神经受压。在淋巴水肿中，由于淋巴结切除，会导致液体积聚，从而导致皮肤内的神经纤维伸展，在神经束上方受压，导致神经受压。这将增加肩部的神经机械敏感性和功能障碍，作为对运动或牵引的保护性神经反应。
这项研究通过评估总共 72 名患有淋巴水肿的乳腺癌幸存者来进行。在 72 名女性中，28 名接受了乳房肿瘤切除术，12 名接受了象限切除术，32 名接受了单侧乳房切除术。通过视觉模拟评分（VAS）评估疼痛，使用量角器评估关节活动度（ROM），使用卷尺评估淋巴水肿，对这些女性的神经组织活动度进行了评估。使用肢体张力测试测量正中神经、尺神经和桡神经的神经组织活动度。
从这项研究中获得的结果表明，患有淋巴水肿的乳腺癌幸存者的神经组织活动度明显受损。上肢张力测试的结果显示，32 名轻度淋巴水肿的女性在受累侧的正中神经受到影响，占 54.1%，约 21 名中度淋巴水肿的女性中有 75%的女性有正中神经和 25%的尺神经受到影响，大多数女性的正中神经受到影响。只有 19 名患有严重淋巴水肿的女性有所有三条神经受到影响。
这项对接受过乳腺癌手术干预的女性的研究得出结论，在手术后 6 个月，对机械激发试验进行术后检查，发现有大量神经组织损伤。研究表明，淋巴水肿的严重程度与神经组织损伤引起的神经受累直接相关。
