Observational studyANZ journal of surgery
Long-Term Shoulder Dysfunction After Breast and Axillary Surgery: Impact of Surgical Extent and Predictors of Function.
Observational study in ANZ journal of surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05950685 (Development of a Screening Tool for Prediction of Long-term Arm Morbidity Following Breast Cancer Surgeries and Treatments), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Development of a Screening Tool for Prediction of Long-term Arm Morbidity Following Breast Cancer Surgeries and Treatments
Who cites it
0 citing papers in PubMed.
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate long-term shoulder outcomes after sentinel lymph-node biopsy (SLNB) versus axillary lymph-node dissection (ALND) and identify predictors of chronic shoulder dysfunction. MATERIAL AND
methodsThis prospective multicenter study enrolled 1111 women (≥ 18 years) undergoing breast cancer surgery with SLNB (n = 931) or ALND (n = 180) across five tertiary hospitals between October 2022 and June 2024. Functional outcomes were assessed using QuickDASH, range-of-motion (ROM), daily-activity limitations, pain, axillary web syndrome (AWS), and lymphedema. Multivariable regression identified independent predictors of poor shoulder function.
resultsALND was associated with consistently greater morbidity. Mean QuickDASH scores were 17.1 ± 10.5 after ALND versus 11.5 ± 9.8 after SLNB (p < 0.001). ROM limitation (38.3% vs. 20.0%), reduced daily-activity performance (41.1% vs. 23.1%), AWS (13.9% vs. 7.0%), and lymphedema (16.1% vs. 4.2%) were all more frequent after ALND (p ≤ 0.002). Pain intensity was higher (2.28 ± 2.82 vs. 1.31 ± 2.11; p < 0.001). In multivariable analysis, ALND (β = 1.18, p < 0.001), higher BMI (β = 0.27, p = 0.001), and depressive disorders (β = 0.31, p < 0.001) independently predicted worse shoulder function; age and physiotherapy timing were not significant. Functional deficits persisted across lumpectomy and mastectomy subgroups.
conclusionsALND is associated with greater long-term shoulder dysfunction compared with SLNB. Obesity and depressive symptoms exacerbate morbidity, highlighting the importance of comprehensive survivorship rehabilitation.
trial registrationClinicalTrials.gov identifier: NCT05950685.
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