Considering wider myofascial involvement as a possible contributor to upper extremity dysfunction following treatment for primary breast cancer.

BACKGROUND: Breast cancer is the most common malignancy in women. Although scarring is recognized as contributing to limited shoulder movements, compromised tissue gliding in a wider range of fascial and connective tissue structures is under-recognized. AIM: To report on soft tissue patterns in patients with upper limb dysfunction after modified radical mastectomy.
METHODS: Tissue gliding was assessed in the neck, chest wall, abdomen, axilla and upper arm. Scarring, areas and directions of tightness were mapped on upper body charts.
RESULTS: Eighteen shoulders were evaluated. All patients had combinations of restrictive tissue gliding and shoulder movements. Four dominant restrictive areas were identified-surgical scarring, axillary tightness radiating into the upper arm, lateral chest wall and posterior tightness over the teres major muscle. DISCUSSION: Breast cancer treatment results in tissues losing their shearing and gliding ability. Mapped restrictive tissue gliding clearly shows wider than reported restrictions. This pattern needs further research and investigation.