Immediate versus delayed shoulder exercises after axillary lymph node dissection

Area of Science:

• Oncology
• Surgical Oncology
• Rehabilitation Medicine

Background:

• Axillary lymph node dissection (ALND) is a common procedure for breast cancer staging.
• Postoperative shoulder dysfunction and wound complications are concerns following ALND.
• The optimal timing for initiating shoulder exercises after ALND is not well-established.

Purpose of the Study:

• To investigate the effect of delayed versus early shoulder exercises on wound drainage and shoulder function post-ALND.
• To compare wound complications and seroma formation between early and delayed exercise groups.

Main Methods:

• A multicenter, randomized, prospective study involving 144 breast cancer patients undergoing ALND.
• Group 1: Active shoulder exercises initiated 1 day postoperatively.
• Group 2: Shoulder exercises initiated on postoperative day 8, after 1 week of arm immobilization.

Main Results:

• Group 2 showed 14% less wound drainage volume (600 ± 436 mL vs. 701 ± 398 mL), but this difference was not statistically significant.
• No significant differences were observed between groups in wound drainage duration, seroma aspirations, wound complication rates, or shoulder function at 6 months.

Conclusions:

• Delayed initiation of shoulder exercises following ALND does not offer significant benefits regarding wound drainage or shoulder function compared to early initiation.
• Early active shoulder exercises appear to be a safe and effective approach after ALND, comparable to delayed exercises.