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. 2010 Jun;4(2):167-78.
doi: 10.1007/s11764-010-0118-x. Epub 2010 Apr 7.

Upper extremity impairments in women with or without lymphedema following breast cancer treatment

Betty Smoot  1 , Josephine Wong, Bruce Cooper, Linda Wanek, Kimberly Topp, Nancy Byl, Marylin Dodd
Affiliations

Upper extremity impairments in women with or without lymphedema following breast cancer treatment

Betty Smoot et al. J Cancer Surviv. 2010 Jun.

Abstract

Introduction: Breast-cancer-related lymphedema affects approximately 25% of breast cancer (BC) survivors and may impact use of the upper limb during activity. The purpose of this study is to compare upper extremity (UE) impairment and activity between women with and without lymphedema after BC treatment.

Methods: 144 women post BC treatment completed demographic, symptom, and Disability of Arm-Shoulder-Hand (DASH) questionnaires. Objective measures included Purdue pegboard, finger-tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume.

Results: Women with lymphedema had more lymph nodes removed (p < .001), more UE symptoms (p < .001), higher BMI (p = .041), and higher DASH scores (greater limitation) (p < .001). For all participants there was less strength (elbow flexion, wrist flexion, grip), less shoulder ROM, and decreased sensation at the medial upper arm (p < .05) in the affected UE. These differences were greater in women with lymphedema, particularly in shoulder abduction ROM (p < .05). Women with lymphedema had bilaterally less elbow flexion strength and shoulder ROM (p < .05). Past diagnosis of lymphedema, grip strength, shoulder abduction ROM, and number of comorbidities contributed to the variance in DASH scores (R (2) of 0.463, p < .001).

Implications for cancer survivors: UE impairments are found in women following treatment for BC. Women with lymphedema have greater UE impairment and limitation in activities than women without. Many of these impairments are amenable to prevention measures or treatment, so early detection by health care providers is essential.

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Figure 1
Figure 1
Shoulder abduction range of motion (in degrees).
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