M Ortí-Asencio1, S Salinas-Huertas2, A Luzardo-González2, J Terra-Falótico2, R Planas-Balagué2,3. 1. Department of Rehabilitation, Hospital Universitari Bellvitge, Carrer de la Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. Meritxell.o.a@gmail.com. 2. Department of Rehabilitation, Hospital Universitari Bellvitge, Carrer de la Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. 3. Universitat de Barcelona, Barcelona, Spain.
Abstract
INTRODUCTION: One of the most common complications of the surgical treatment of breast cancer is limited range-of-motion in the shoulder. Scapular winging is one of the most underdiagnosed shoulder mobility impairments. OBJECTIVE: The main objective of this study was to determine the incidence of scapular winging in patients who underwent breast cancer surgery as the basis for expanding the protocol to patients who have had a sentinel lymph node biopsy. The secondary objective was to determine the risk factors that lead to the development of a winged scapula presented after breast cancer treatment in our sample. METHODS: This was a prospective, observational, and multidisciplinary study. Between 2013 and 2018, 214 consecutive patients who had been diagnosed with breast cancer and treated for it surgically were followed by Rehabilitation Department for 3 years. The patients were evaluated in the 1st, 6th, 12th, 18th, 24th and 36th months following surgery. Scapular winging was evaluated at each visit by means of static and dynamic tests. RESULTS: The cumulative incidence of scapular winging was 3.6% and seven cases of winged scapula were diagnosed. All the cases were diagnosed at the first visit, 1 month after the intervention. In the univariate analysis, the axillary lymph node dissection technique was a more significant risk factor for a winged scapula than sentinel lymph node biopsy. CONCLUSIONS: The axillary lymph node dissection technique is a risk factor for developing a winged scapula. No evidence was found for any other significant risk factor.
INTRODUCTION: One of the most common complications of the surgical treatment of breast cancer is limited range-of-motion in the shoulder. Scapular winging is one of the most underdiagnosed shoulder mobility impairments. OBJECTIVE: The main objective of this study was to determine the incidence of scapular winging in patients who underwent breast cancer surgery as the basis for expanding the protocol to patients who have had a sentinel lymph node biopsy. The secondary objective was to determine the risk factors that lead to the development of a winged scapula presented after breast cancer treatment in our sample. METHODS: This was a prospective, observational, and multidisciplinary study. Between 2013 and 2018, 214 consecutive patients who had been diagnosed with breast cancer and treated for it surgically were followed by Rehabilitation Department for 3 years. The patients were evaluated in the 1st, 6th, 12th, 18th, 24th and 36th months following surgery. Scapular winging was evaluated at each visit by means of static and dynamic tests. RESULTS: The cumulative incidence of scapular winging was 3.6% and seven cases of winged scapula were diagnosed. All the cases were diagnosed at the first visit, 1 month after the intervention. In the univariate analysis, the axillary lymph node dissection technique was a more significant risk factor for a winged scapula than sentinel lymph node biopsy. CONCLUSIONS: The axillary lymph node dissection technique is a risk factor for developing a winged scapula. No evidence was found for any other significant risk factor.
Authors: Gregory J Galano; Louis U Bigliani; Christopher S Ahmad; William N Levine Journal: Clin Orthop Relat Res Date: 2008-01-08 Impact factor: 4.176
Authors: W Ben Kibler; Paula M Ludewig; Phil W McClure; Lori A Michener; Klaus Bak; Aaron D Sciascia Journal: Br J Sports Med Date: 2013-04-11 Impact factor: 13.800
Authors: Lanell Bellury; Marjorie A Pett; Lee Ellington; Susan L Beck; Jane C Clark; Kevin D Stein Journal: Cancer Date: 2012-06-06 Impact factor: 6.860
Authors: Luiz Felipe Nevola Teixeira; Visnu Lohsiriwat; Mario Casales Schorr; Alberto Luini; Viviana Galimberti; Mario Rietjens; Cristina Garusi; Sara Gandini; Luis Otavio Zanatta Sarian; Fabio Sandrin; Maria Claudia Simoncini; Paolo Veronesi Journal: Support Care Cancer Date: 2014-02-04 Impact factor: 3.603
Authors: Nele Adriaenssens; Mark De Ridder; Pierre Lievens; Hilde Van Parijs; Marian Vanhoeij; Geertje Miedema; Mia Voordeckers; Harijati Versmessen; Guy Storme; Jan Lamote; Stephanie Pauwels; Vincent Vinh-Hung Journal: World J Surg Oncol Date: 2012-05-16 Impact factor: 2.754