Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors

Chun,  Mi Son; Moon,  Seong Mi; Lee,  Hye Jin; Lee,  Eun Hyun; Song,  Yeoung Suk; Chung,  Yong Sik; Park,  Hee Bung; Kang,  Seung Hee

J Korean Soc Ther Radiol Oncol > Volume 23(1); 2005 > Article

Original Article

The Journal of the Korean Society for Therapeutic Radiology and Oncology 2005;23(1): 32-42.

Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors

Mi Son Chun, Seong Mi Moon, Hye Jin Lee, Eun Hyun Lee, Yeoung Suk Song, Yong Sik Chung, Hee Bung Park, Seung Hee Kang

¹Departments of Radiation Oncology, College of Medicine, Ajou University, Korea. chunm@ajou.ac.kr
²Departments of General Surgery, College of Medicine, Ajou University, Korea.
³Departments of Radiation Oncology, Ajou University Hospital, Korea.
⁴Graduate School of Nursing, Yonsei University, Korea.
⁵Graduate School of Public Health, Ajou University, Korea.
⁶Hee Bung Park Breast Clinic, Korea.

ABSTRACT

PURPOSE:
To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. MATERIASL AND
METHODS:
One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed.
RESULTS:
The incidence of lymphedema (> or =2 cm difference comparing to unaffected arm) was 6.3%, 10.7%, 22.6% and 23.3% at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint (> or =20 degree difference comparing to unaffected arm) was noted in more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe (> 50% reduction) in 1/3 patients. Approximately 50 to 60% of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema.
CONCLUSION:
Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation in shoulder joint should be developed.

Key Words: Arm morbidity, Axillary dissection, Breast cancer