Comparison of Shoulder-Arm Complex Pain, Function, and Scapular Dyskinesia in Women With and Without Unilateral Lymphedema After Breast Cancer Surgery

Lymphedema is the most important complication seen after breast cancer surgery. The study aimed to evaluate pain, shoulder-arm complex function, and scapular function in women who developed lymphedema after breast cancer surgery and to compare these with women without lymphedema. Fifty women with lymphedema (age, 54.34 ± 9.08 years; body mass index, 30.10 ± 4.03 kg/cm2) and 57 women without lymphedema (age, 53.68 ± 9.41 years; body mass index, 29.0 ± 5.44 kg/cm2) after unilateral surgery for breast cancer were included. Clinical and demographic information was noted. The severity of lymphedema with perimeter measurements (Frustum model), level of heaviness discomfort sensation with a visual analog scale, pain threshold with a digital algometer, shoulder-arm complex functionality with the Disabilities of the Arm, Shoulder, Hand Problems Survey (DASH), and scapular function with observational scapular dyskinesia and lateral scapular sliding tests were assessed. The t test, χ2 test, and Mann-Whitney U test were used for analyses. The follow-up duration after the surgery was 4.24 ± 2.97 years and 3.19 ± 1.76 years, and the upper extremity volume was 2106.65 ± 510.82 cm3 and 1725.92 ± 342.49 cm³ in the lymphedema group and in the no-lymphedema group, respectively. In the lymphedema group, arm-heaviness discomfort, pain threshold levels in the trapezius and deltoid muscles, and DASH scores were worse (P < .05). The rate of scapular dyskinesia (70.0%) and type 2 scapula (32%) in the surgical side was higher in patients with lymphedema. The pain pressure threshold in the trapezius and deltoid muscles, heaviness sensation level, and inadequate upper extremity function are significantly higher in patients with lymphedema, and the scapular dyskinesia rate was higher. One hundred seven patients aged between 25 and 65 years who had undergone a unilateral mastectomy or lumpectomy (2 groups: women with lymphedema [n = 50] and women without lymphedema [n = 57]) were investigated. Women with unilateral lymphedema after breast cancer surgery had considerable differences in the pain pressure threshold of the trapezius and deltoid muscles, heaviness sensation level, and altered scapular kinematics.