scholarly journals Movement, Function, Pain, and Postoperative Edema in Axillary Web Syndrome

2015 ◽  
Vol 95 (10) ◽  
pp. 1345-1353 ◽  
Author(s):  
Linda A. Koehler ◽  
Anne H. Blaes ◽  
Tuffia C. Haddad ◽  
David W. Hunter ◽  
Alan T. Hirsch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Dielectric Constant ◽  
Range Of Motion ◽  
Body Mass ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph ◽  
Axillary Web Syndrome ◽  
Movement Function

Background Axillary web syndrome (AWS) is a condition that may develop following breast cancer surgery and that presents as a palpable axillary cord of tissue. Objective The purposes of this study were: (1) to determine the clinical characteristics of AWS related to movement, function, pain, and postoperative edema and (2) to define the incidence of and risk factors for AWS within the first 3 months following breast cancer surgery. Design This was a prospective cohort study with a repeated-measures design. Methods Women who underwent breast cancer surgery with sentinel node biopsy or axillary lymph node dissection (N=36) were assessed for AWS, shoulder range of motion, function, pain, and postoperative edema (using girth measurements, bioimpedance, and tissue dielectric constant) at 2, 4, and 12 weeks. Demographic characteristics were used for risk analysis. Results Seventeen women (47.2%) developed AWS, and AWS persisted in 10 participants (27.8%) at 12 weeks. Abduction range of motion was significantly lower in the AWS group compared with the non-AWS group at 2 and 4 weeks. There were no differences between groups in measurements of function, pain, or edema at any time point. Trunk edema measured by dielectric constant was present in both groups, with an incidence of 55%. Multivariate analysis determined lower body mass index as being significantly associated with AWS (odds ratio=0.86; 95% confidence interval=0.74, 1.00). Limitations Limitations included a short follow-up time and a small sample size. Conclusion Axillary web syndrome is prevalent following breast/axilla surgery for early-stage breast cancer and may persist beyond 12 weeks. The early consequences include movement restriction, but the long-term effects of persistent AWS cords are yet unknown. Low body mass index is considered a risk factor for AWS.

High Body Mass Index and Smoking Predict Morbidity in Breast Cancer Surgery

2012 ◽  
Vol 255 (3) ◽  
pp. 551-555 ◽  
Author(s):  
Catherine de Blacam ◽  
Adeyemi A. Ogunleye ◽  
Adeyiza O. Momoh ◽  
Salih Colakoglu ◽  
Adam M. Tobias ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
High Body Mass Index ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
High Body

scholarly journals Body mass index and persistent pain after breast cancer surgery: findings from the women’s healthy eating and living study and a meta-analysis

Oncotarget ◽  
2017 ◽  
Vol 8 (26) ◽  
pp. 43332-43343 ◽  
Author(s):  
Yuan-Yuan Ding ◽  
Peng Yao ◽  
Lang Wu ◽  
Zhen-Kai Han ◽  
Tao Hong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Healthy Eating ◽  
Meta Analysis ◽  
Persistent Pain ◽  
Cancer Surgery ◽  
Breast Cancer Surgery

scholarly journals Function, Shoulder Motion, Pain, and Lymphedema in Breast Cancer With and Without Axillary Web Syndrome: An 18-Month Follow-Up

2018 ◽  
Vol 98 (6) ◽  
pp. 518-527 ◽  
Author(s):  
Linda A Koehler ◽  
David W Hunter ◽  
Anne H Blaes ◽  
Tufia C Haddad
Keyword(s):  
Breast Cancer ◽  
Range Of Motion ◽  
Small Sample ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Shoulder Abduction ◽  
Repeated Measures Design ◽  
Axillary Web Syndrome ◽  
Shoulder Range Of Motion ◽  
And Function

Abstract Background Axillary web syndrome (AWS) can develop following breast cancer surgery and presents as a tight band of tissue in the axilla with shoulder abduction. Objective The objectives were to determine the prevalence and natural history of AWS and the association between AWS and function, range of motion, pain, lymphedema, and body mass index (BMI). Design This study was a longitudinal prospective cohort study utilizing a repeated measures design. Methods Axillary web syndrome, function, shoulder range of motion, pain, and lymphedema (using circumference, bioimpedance spectroscopy, tissue dielectric constant) were assessed in women at 2, 4, and 12 weeks and 18 months following breast cancer surgery. Prevalence of AWS and the association with the measured outcomes were analyzed. Results Thirty-six women agreed to participate in the study. The cumulative prevalence of AWS was 50% (18/36) at 18 months following breast cancer surgery. AWS was identified as a risk factor for reduced function. Women with AWS had statistically reduced range of motion, lower BMI, and higher number of lymph nodes removed compared to the non-AWS group. Forty-one percent (13/32) of women had AWS at 18 months. AWS reoccurred in 6 women following resolution, and a new case developed beyond the early postoperative period. The overall prevalence of physical impairments ranged from 66% to 97% within the first 18 months following surgery regardless of AWS. Limitations Limitations include a small sample size and potential treatment effect. Conclusion AWS occurs in approximately 50% of women following breast cancer surgery. It can persist for 18 months and potentially longer, develop beyond the early postoperative time period, and reoccur after resolution. Clinicians need to be aware of the chronicity of AWS and its association with reduced range of motion and function.

Impact of Body Mass Index on Outcomes After Breast Cancer Surgery: Nationwide Inpatient Database Study in Japan

2020 ◽  
Vol 20 (6) ◽  
pp. e663-e674 ◽  
Author(s):  
Takaaki Konishi ◽  
Michimasa Fujiogi ◽  
Nobuaki Michihata ◽  
Kojiro Morita ◽  
Hiroki Matsui ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Database Study ◽  
Inpatient Database

Prognostic significance of body mass index in breast cancer patients with hormone receptor-positive tumours after curative surgery

2013 ◽  
Vol 36 (6) ◽  
pp. 297 ◽  
Author(s):  
Peng Xing ◽  
Ji-Guang Li ◽  
Feng Jin ◽  
Ting-Ting Zhao ◽  
Qun Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Hormone Receptor ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Axillary Lymph ◽  
Nodal Stage ◽  
Hormone Receptor Positive ◽  
High Bmi

Purpose: Obesity has been recognized as a significant risk factor for postmenopausal breast cancer. The aim of this study is to investigate the prognostic significance of body mass index (BMI) in hormone receptor-positive, operable breast cancer. Methods: In this retrospective cohort study, 1,192 consecutive patients with curative resection of primary breast cancer were enrolled. Patients were assigned to two groups according to BMI: normal or underweight (BMI < 23.0 kg/m2) and overweight or obese (BMI ≥23.0 kg/m2). Associations among BMI and clinicopathological characteristics and prognosis of patients were assessed. Results: A high BMI was significantly (P < 0.01) correlated with age, nodal stage, ALNR, ER positivity, PR positivity and menopausal status at diagnosis. Univariate analysis revealed that BMI, pathologic T stage, nodal stage, axillary lymph node ratio (ALNR) and adjuvant radiotherapy history were significantly (P < 0.05) associated with disease-free survival and overall survival, irrespective of tumour hormone receptor status. Multivariate analysis revealed BMI as an independent prognostic factor in all cases and in hormone receptor-positive cases. Conclusion: A high BMI (≥23.0 kg/m^2) is independently associated with poor prognosis in hormone receptor-positive breast cancer.

scholarly journals The Findings of SPECT/CT Concerning Bypass Lymph Circulation in Lymphedema Following Breast Cancer Surgery

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 471
Author(s):  
Min Young Lee ◽  
Eunjung Kong ◽  
Dong Gyu Lee
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymphatic Drainage ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Positive Group

This study aimed to determine whether bypass circulation was present in lymphedema and its effect. This was a retrospective, cross-sectional study. Patients who underwent unilateral breast cancer surgery with axillary lymph node dissection were recruited and underwent single-photon emission tomography/computed tomography (SPECT/CT). SPECT/CT was performed to detect the three-dimensional locations of radio-activated lymph nodes. Patients with radioactivity in anatomical locations other than axillary lymph nodes were classified into a positive group. All patients received complete decongestive therapy (CDT). Exclusion criteria were as follows: History of bilateral breast cancer surgery, cervical lymph node dissection history, and upper extremity amputation. The difference in the upper extremity circumference (cm) was measured at four points: Mid-point of the upper arm, elbow, and 10 and 15 cm below the elbow. Twenty-nine patients were included in this study. Fifteen patients (51.7%) had bypass lymphatic systems on the affected side, six (20.7%) had a bypass lymphatic system with axillary lymph nodes on the unaffected side, and 11 (37.9%) showed new lymphatic drainage. The positive group showed significantly less swelling than the negative group at the mid-arm, elbow, and 15 cm below the elbow. Bypass lymphatic circulation had two patterns: Infraclavicular lymph nodes and supraclavicular and/or cervical lymph nodes. Changes in lymph drainage caused by surgery triggered the activation of the superficial lymphatic drainage system to relieve lymphedema. Superficial lymphatic drainage has a connection through the deltopectoral groove.

scholarly journals Predictors of Unemployment After Breast Cancer Surgery: A Systematic Review and Meta-Analysis of Observational Studies

2018 ◽  
Vol 36 (18) ◽  
pp. 1868-1879 ◽  
Author(s):  
Li Wang ◽  
Brian Y. Hong ◽  
Sean A. Kennedy ◽  
Yaping Chang ◽  
Chris J. Hong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Observational Studies ◽  
Job Demands ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph ◽  
High Quality ◽  
Moderate Quality ◽  
High Quality Evidence ◽  
Quality Evidence

Purpose Breast cancer surgery is associated with unemployment. Identifying high-risk patients could help inform strategies to promote return to work. We systematically reviewed observational studies to explore factors associated with unemployment after breast cancer surgery. Methods We searched MEDLINE, EMBASE, CINAHL, and PsycINFO to identify studies that explored risk factors for unemployment after breast cancer surgery. When possible, we pooled estimates of association for all independent variables reported by more than one study. Results Twenty-six studies (46,927 patients) reported the association of 127 variables with unemployment after breast cancer surgery. Access to universal health care was associated with higher rates of unemployment (26.6% v 15.4%; test of interaction P = .05). High-quality evidence showed that unemployment after breast cancer surgery was associated with high psychological job demands (odds ratio [OR], 4.26; 95% CI, 2.27 to 7.97), childlessness (OR, 1.30; 95% CI, 1.11 to 1.53), lower education level (OR, 1.15; 95% CI, 1.05 to 1.25), lower income level (OR, 1.46; 95% CI, 1.24 to 1.73), cancer stage II, III or IV (OR, 1.43; 95% CI, 1.13 to 1.82), and mastectomy versus breast-conserving surgery (OR, 1.18; 95% CI, 1.07 to 1.30). Moderate-quality evidence suggested an association with high physical job demands (OR, 2.11; 95%CI, 1.52 to 2.93), African-American ethnicity (OR, 1.89; 95% CI, 1.21 to 2.96), and receipt of chemotherapy (OR, 1.95; 95% CI, 1.36 to 2.79). High-quality evidence demonstrated no significant association with part-time hours, blue-collar work, tumor size, positive lymph nodes, or receipt of radiotherapy or endocrine therapy; moderate-quality evidence suggested no association with age, marital status, or axillary lymph node dissection. Conclusion Addressing high physical and psychological job demands may be important in reducing unemployment after breast cancer surgery.

Clinical Prediction Model and Tool for Assessing Risk of Persistent Pain After Breast Cancer Surgery

2017 ◽  
Vol 35 (15) ◽  
pp. 1660-1667 ◽  
Author(s):  
Tuomo J. Meretoja ◽  
Kenneth Geving Andersen ◽  
Julie Bruce ◽  
Lassi Haasio ◽  
Reetta Sipilä ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Prediction Model ◽  
Prediction Models ◽  
Persistent Pain ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Outcome Variable ◽  
Axillary Lymph ◽  
Operating Characteristics

Purpose Persistent pain after breast cancer surgery is a well-recognized problem, with moderate to severe pain affecting 15% to 20% of women at 1 year from surgery. Several risk factors for persistent pain have been recognized, but tools to identify high-risk patients and preventive interventions are missing. The aim was to develop a clinically applicable risk prediction tool. Methods The prediction models were developed and tested using three prospective data sets from Finland (n = 860), Denmark (n = 453), and Scotland (n = 231). Prediction models for persistent pain of moderate to severe intensity at 1 year postoperatively were developed by logistic regression analyses in the Finnish patient cohort. The models were tested in two independent cohorts from Denmark and Scotland by assessing the areas under the receiver operating characteristics curves (ROC-AUCs). The outcome variable was moderate to severe persistent pain at 1 year from surgery in the Finnish and Danish cohorts and at 9 months in the Scottish cohort. Results Moderate to severe persistent pain occurred in 13.5%, 13.9%, and 20.3% of the patients in the three studies, respectively. Preoperative pain in the operative area ( P < .001), high body mass index ( P = .039), axillary lymph node dissection ( P = .008), and more severe acute postoperative pain intensity at the seventh postoperative day ( P = .003) predicted persistent pain in the final prediction model, which performed well in the Danish (ROC-AUC, 0.739) and Scottish (ROC-AUC, 0.740) cohorts. At the 20% risk level, the model had 32.8% and 47.4% sensitivity and 94.4% and 82.4% specificity in the Danish and Scottish cohorts, respectively. Conclusion Our validated prediction models and an online risk calculator provide clinicians and researchers with a simple tool to screen for patients at high risk of developing persistent pain after breast cancer surgery.

The Association of Body Mass Index and Adverse Clinico-Pathological Characteristics of Non-Metastatic Breast Cancer Among Patients from Saudi Arabia

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 8-8
Author(s):  
Bashayer Alghamdi ◽  
Reema Alghamdi ◽  
Raghad Khallaf ◽  
Konooz faisal ◽  
Raghad Bishnaq ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Saudi Arabia ◽  
Lymph Node ◽  
Body Mass ◽  
Tumor Size ◽  
P Value ◽  
Axillary Lymph ◽  
Receptor Status ◽  
The Mean

Background: Obesity is a global health problem, especially in the Arab region, the prevalence of obesity is increasing. High body mass index (BMI) is a risk factor for many diseases, including cancer. Noticeably, breast cancer (BC) cases in Saudi Arabia occur at a younger age than western countries and different life style behaviours such as maintaining healthy body weight and physical activity may play a role in this. In this study, we aimed to investigate the association between BMI and BC clinicopathological features. Methods: This retrospective study was conducted by reviewing the records of females diagnosed with non-metastatic BC over four years. The association between BMI and patients’ demographics, BC histological type, receptor status, differentiation grade, tumor size, involvement of axillary lymph node, and performed procedures was analysed. Result: We studied 315 patients with non-metastatic BC. The mean age at the time of diagnosis was 52.43 years ±11.63. The mean BMI was 30.21±5.77. The mean tumor size was 3.19 cm ± 3.52. We found that the mean age of diagnosis is significantly greater in obese women than other BMI groups with a P-value = 0.025. A significant relationship was observed between BMI classification and tumor size in obese female patients aged ⩾ 40 years with P-value=0.022 Conclusion: The relationship between BMI and BC is still not clear, in this study we found an association with age at diagnosis and tumor size in older patients, characteristics as histological types, receptor status, lymph node involvement, and grade were not statistically significant.

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