Mizuta Mayu, Okumura Maho, Inoue Junichiro, Ueda Yuya, Kondo Shin, Miki Mayuko, Kunihisa Tomonari, Ono Rei, Sakai Yoshitada, Akisue Toshihiro
Division of Rehabilitation, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, 1-5-1, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
Breast Cancer. 2025 Jul;32(4):750-756. doi: 10.1007/s12282-025-01699-2. Epub 2025 Apr 10.
Upper extremity impairments in patients with breast cancer persist after curative surgery. Although postoperative factors associated with upper extremity impairments have been reported, modifiable factors affecting these impairments preoperatively remain unclear. This study aimed to investigate the relationship between preoperative grip strength and postoperative upper extremity impairments in patients with breast cancer.
This retrospective cohort study included patients (age ≥ 18 years) with breast cancer who underwent mastectomy. Maximum grip strength was measured on the day before surgery. Upper extremity impairments were assessed 4-16 months after surgery using the Disabilities of the Arm, Shoulder and Hand (DASH) scale. Multiple linear regression analysis was used to evaluate the association between preoperative grip strength and postoperative upper extremity impairments.
In total, 72 patients were included in the analysis. Multiple linear regression analysis showed that preoperative grip strength was significantly associated with the postoperative DASH score after adjusting for confounding factors (β = - 1.27, 95% confidence interval - 2.08 to - 0.48, p = 0.002).
This study showed that low preoperative grip strength is a risk factor for postoperative upper extremity impairments in patients with breast cancer. Providing prehabilitation to maintain and improve muscle strength immediately after diagnosis is important. Moreover, an individualized follow-up protocol according to preoperative screenings to prevent postoperative upper extremity impairments is necessary.
乳腺癌患者在根治性手术后上肢功能障碍仍然存在。虽然已经报道了与上肢功能障碍相关的术后因素，但术前影响这些功能障碍的可改变因素仍不清楚。本研究旨在探讨乳腺癌患者术前握力与术后上肢功能障碍之间的关系。
这项回顾性队列研究纳入了接受乳房切除术的乳腺癌患者（年龄≥18岁）。在手术前一天测量最大握力。术后4-16个月使用手臂、肩部和手部功能障碍（DASH）量表评估上肢功能障碍。采用多元线性回归分析评估术前握力与术后上肢功能障碍之间的关联。
总共72例患者纳入分析。多元线性回归分析显示，在调整混杂因素后，术前握力与术后DASH评分显著相关（β=-1.27，95%置信区间-2.08至-0.48，p=0.002）。
本研究表明，术前握力低是乳腺癌患者术后上肢功能障碍的一个危险因素。在诊断后立即提供康复前训练以维持和提高肌肉力量很重要。此外，根据术前筛查制定个性化的随访方案以预防术后上肢功能障碍是必要的。
