Shoulder impairment before breast cancer surgery

Area of Science:

• Orthopedics and Rehabilitation
• Oncology
• Physical Therapy

Background:

• The U.S. has a large breast cancer survivor population, with African American survivors facing a disproportionately higher mortality burden.
• African American breast cancer survivors may experience a greater burden of physical and functional side effects compared to White survivors and the general population.

Purpose of the Study:

• To compare pre- and post-operative shoulder active range of motion (AROM) in female breast cancer survivors against population norms.
• To examine differences in shoulder AROM between African American and White female breast cancer survivors before and after surgery.

Main Methods:

• A pilot study with a convenience sample (n=33) used a longitudinal design, measuring shoulder AROM at two time points: pre-surgery (after biopsy) and 2 weeks post-surgery.
• Statistical analyses included t-tests to compare sample AROM to population norms and independent samples t-tests/repeated measures ANOVA to compare AROM between African American and White subgroups.

Main Results:

• All participants (100%) exhibited significantly reduced shoulder AROM in all movements prior to surgery (post-biopsy) compared to population norms.
• African American survivors showed significantly less shoulder abduction pre-surgery and less shoulder flexion post-surgery compared to White survivors.

Conclusions:

• The significant decrease in shoulder AROM after biopsy but before surgery suggests a potential unmet need for early physical therapy interventions.
• Further research, ideally using a randomized controlled trial design, is recommended to investigate these findings and inform clinical practice.