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Titre : | Five-Year Cumulative Incidence of Axillary Web Syndrome and Comparison in Upper Extremity Movement, Function, Pain, and Lymphedema in Survivors of Breast Cancer With and Without Axillary Web Syndrome (2022) |
Auteurs : | Linda Koehler ; Amanda Day ; David Hunter ; Anne Blaes ; Tufia Haddad ; Ryan Shanley ; Ryan Shanley |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 103, n° 9, 2022) |
Article en page(s) : | p. 1798-1806 |
Note générale : | https://doi.org/10.1016/j.apmr.2022.03.007 |
Langues: | Français |
Descripteurs : |
HE Vinci Incidence ; Lymphoedeme ; Réadaptation ; Tumeurs du sein |
Résumé : | Objective To determine the cumulative incidence and natural history of axillary web syndrome (AWS) and its related postoperative risk for physical impairments in a cohort of women followed for 5 years post breast cancer surgery. Design Prospective, longitudinal study. Setting Academic health center. Participants Women (N=36) with and without AWS after breast cancer surgery with sentinel node biopsy or axillary lymph node dissection. Interventions Not applicable. Main Outcome Measures Participants were assessed for AWS, shoulder goniometric flexion and abduction range of motion, function (Disability of the Arm, Shoulder, and Hand), lymphedema (bioimpedance spectroscopy, girth measures, tissue dielectric constant), and pain (visual analog scale) at 2, 4, 12, and 78 weeks and 5 years after breast cancer surgery. Analysis of variance compared range of motion, function, lymphedema, and pain in women identified with AWS with those without AWS across visits. Univariate logistic regression assessed if AWS was a risk factor for physical impairment at 5 years. Results The cumulative incidence of AWS was 57%. Fifty percent (14/28) of the women who completed all study visits had signs of AWS at 5 years. Abduction active range of motion was significantly lower in women with AWS at 2 and 4 weeks post surgery. AWS was identified as a risk factor for reduced shoulder motion at 5 years. Regardless of AWS, 75% of the women experienced 1 or more upper extremity physical impairments at 5 years, which is an increase from 66% at 78 weeks in the same cohort. Conclusions AWS is associated with reduced shoulder range of motion in the early postoperative time period, can persist for 5 years after breast cancer surgery, and increases the risk of long-term reduced shoulder range of motion. Long-term physical issues are apparent after breast cancer surgery regardless of AWS. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S000399932200291X |