title: Arm lymphoedema and upper limb impairments in sentinel node-negative breast cancer patients: A one year follow-up study.
abstract: OBJECTIVE
  The aim of this study is (1) to investigate the prevalence rate of arm lymphedema, pain, impaired shoulder range of motion, strength and shoulder function one year after a sentinel lymph node biopsy (SLNB) for breast cancer and (2) to determine predictive factors for these complications.
  
  
  METHODS
  A longitudinal study was performed. One hundred patients with a sentinel-lymph node negative breast cancer were included. All patients were measured before surgery and one year after. Arm lymphedema was measured with the perimeter, pain with the Visual Analogue Scale, shoulder range of motion with an inclinometer, strength with a handheld dynamometer and shoulder function with the Disability of Arm, Shoulder and Hand questionnaire. Patient-, breast cancer- and treatment-related variables were recorded.
  
  
  RESULTS
  One year after surgery 8% of sentinel node-negative breast cancer patients had developed arm lymphedema. Fifty percent of patients had pain, 30% had an impaired shoulder range of motion, 8% had a decreased handgrip strength and 49% had an impaired shoulder function. Pain, shoulder range of motion, strength and shoulder dysfunctions changed significantly over one year (p < 0.001). Higher Body Mass Index is a predictive variable for shoulder dysfunctions one year post-SLNB.
  
  
  CONCLUSIONS
  Prevalence rate of lymphedema and other upper limb impairments may not be underestimated after SLNB. Pain, shoulder range of motion, handgrip strength and shoulder function change significantly up to one year compared to preoperative values in sentinel node-negative breast cancer patients.
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium. Electronic address: an.degroef@faber.kuleuven.be.
authors.forename: An
authors.initials: A
authors.lastname: De Groef
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium.
authors.forename: Marijke
authors.initials: M
authors.lastname: Van Kampen
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium.
authors.forename: Elena
authors.initials: E
authors.lastname: Tieto
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium.
authors.forename: Petra
authors.initials: P
authors.lastname: Schönweger
authors.affiliation: Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, Oncology Department, Department of Surgical Oncology, Belgium.
authors.forename: Marie-Rose
authors.initials: MR
authors.lastname: Christiaens
authors.affiliation: Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Neven
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Geraerts
authors.affiliation: Univeristy of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium.
authors.forename: Nick
authors.initials: N
authors.lastname: Gebruers
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Devoogdt
mesh_terms: D000368:Aged; D001132:Arm / Q000503:physiopathology; D000072656:Breast Cancer Lymphedema / Q000453:epidemiology*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000209:etiology; D059352:Musculoskeletal Pain / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D016059:Range of Motion, Articular; D000071036:Sentinel Lymph Node / Q000473:pathology* / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects*; D012782:Shoulder / Q000503:physiopathology; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology
keywords: Breast neoplasms; Lymphedema; Sentinel lymph node biopsy; Shoulder morbidity