One of the complications of the breast cancer (BC) treatment is the limitation of mobility in the shoulder on the side of the surgery. The prevalence and predictors of this complication should be determined to develop an organizational model of rehabilitation.

OBJECTIVE

To study the incidence and interrelated causes of impaired volume and freedom of movement in the shoulder in breast cancer patients after treatment.

MATERIAL AND METHODS

A retrospective study involved 1938 women (mean age, 50.82 years) who underwent treatment for breast cancer. The dependence of the incidence of the shoulder dysfunction from the type of surgery, methods of additional treatment and the postoperative period course were analyzed. Yates’s correction for continuity was used to test the null hypothesis in MS Excel.

RESULTS

Of 1938 patients, 1017 (52.5%) patients had limited range of motion in the shoulder, of which I degree was in 39.9%, II — in 43.8%, III — in 15.5% and IV — in 0.8%. There was no statistical significance between the type of radical mastectomy or additional treatment and the incidence of complication. However, for the radical resection a decrease in the incidence was noted (43.3% vs. 50.7% for Madden mastectomy). The increase in the incidence and degree of shoulder function impairment was associated with age of patients (>55 y.o.) (p=0.029), early wound complications (p<0.001): massive lymphatic leakage, suppuration, suture dehiscence. Concomitant cardiovascular or metabolic diseases were associated with increase in the incidence of wound complications (p<0.05). No physical therapy in the early postoperative period was associated with the most significant (p<0.001) increase in the incidence of impaired shoulder function. In the majority of cases attending doctors prohibited physical therapy because of wound complications, and, in their opinion, the possibility of worsening of the patient’s condition. However, early start of physical therapy did not affect the amount and duration of lymphorrhea and the wound dehiscence rates.

CONCLUSIONS

The model of continuous comprehensive medical rehabilitation of patients should implemented in each medical institution, starting from the preoperative period.