Wolfram Susann, Herriman Skyelar A, Lipps David B
School of Kinesiology, University of Michigan, Ann Arbor, MI, 48109, USA.
Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.
Breast Cancer Res Treat. 2025 Feb;209(3):553-561. doi: 10.1007/s10549-024-07514-4. Epub 2024 Oct 21.
Subacromial impingement is a painful shoulder disorder, which may be common after breast cancer treatment. A previous study showed a high prevalence after mastectomy but prevalence after conservatively treated patients is unknown. Impingement mechanisms in breast cancer survivors have not been studied.
Twenty-four breast cancer survivors who had undergone breast-conserving surgery without axillary lymph node dissection followed by radiation therapy, and 12 cancer-free controls were included. Breast cancer survivors were grouped by the presence of subacromial impingement pain. The subacromial space and the supraspinatus tendon were imaged using ultrasound on the treated side in the breast cancer survivors and a randomly chosen side in controls. In these images, the width of the subacromial space, thickness of the supraspinatus tendon and combined thickness of the supraspinatus tendon and surrounding soft tissues were measured.
Subacromial impingement prevalence among breast cancer survivors was 54%. The width of the subacromial space and the thickness of the supraspinatus tendon were not different in breast cancer survivors with subacromial impingement compared to breast cancer survivors without subacromial impingement and controls. Combined thickness of the supraspinatus tendon and surrounding soft tissues was grater in breast cancer survivors with subacromial impingement.
Prevalence of subacromial impingement is high, even in the most conservatively treated breast cancer patients. The presence of subacromial impingement pain is unrelated to width of the subacromial space, but greater thickness of the supraspinatus tendon and surrounding soft tissue may be part of the impingement mechanism.
肩峰下撞击综合征是一种引起肩部疼痛的疾病，在乳腺癌治疗后可能较为常见。先前的一项研究显示乳房切除术后该疾病的患病率较高，但保守治疗患者的患病率尚不清楚。尚未对乳腺癌幸存者的撞击机制进行研究。
纳入24例接受保乳手术且未进行腋窝淋巴结清扫、随后接受放射治疗的乳腺癌幸存者，以及12例无癌对照者。乳腺癌幸存者根据是否存在肩峰下撞击疼痛进行分组。在乳腺癌幸存者的患侧以及对照者中随机选择的一侧，使用超声对肩峰下间隙和冈上肌腱进行成像。在这些图像中，测量肩峰下间隙的宽度、冈上肌腱的厚度以及冈上肌腱和周围软组织的总厚度。
乳腺癌幸存者中肩峰下撞击综合征的患病率为54%。与无肩峰下撞击的乳腺癌幸存者及对照者相比，有肩峰下撞击的乳腺癌幸存者的肩峰下间隙宽度和冈上肌腱厚度并无差异。有肩峰下撞击的乳腺癌幸存者的冈上肌腱和周围软组织的总厚度更大。
即使是接受最保守治疗的乳腺癌患者，肩峰下撞击综合征的患病率也很高。肩峰下撞击疼痛的存在与肩峰下间隙的宽度无关，但冈上肌腱和周围软组织厚度增加可能是撞击机制的一部分。
