乳腺癌手术后新确诊患者的腋窝网状结构综合征:AMBER 队列研究的基线结果

Pub Date : 2024-06-06 DOI:10.3138/ptc-2023-0088
Margaret L McNeely, K. S. Courneya, Mona M. Al Onazi, Qinggang Wang, Stephanie Bernard, Leanne Dickau, Jeff K. Vallance, S. Culos-Reed, Charles E Matthews, Lin Yang, C. Friedenreich
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引用次数: 0

摘要

目的:研究新诊断的乳腺癌患者手术后腋窝网综合征(AWS)与人口统计学、医疗、手术和健康相关的体能变量之间的潜在关联。参与者招募时间为 2012 年至 2019 年。在乳腺癌手术后 3 个月内,对健康相关体能、身体成分、肩关节活动范围 (ROM) 和功能以及 AWS 进行了客观测量。在 243 名(17.3%)参与者中发现了 AWS,与没有 AWS 的女性相比,AWS 与较差的肩关节活动度和功能以及较高的疼痛有关。多变量逻辑回归分析发现,腋窝淋巴结清扫与前哨淋巴结活检[OR = 3.97; 95% CI: 2.62, 6.03]、乳房切除术与保乳手术[OR = 1.60, 95% CI: 1.17,2.19]、体脂总百分比较低与较高[OR = 1.60;95% CI:1.10,2.34]以及手术时间较早与较晚[OR:1.56;95% CI:1.10,2.23]与较高的 AWS 机率显著相关。较高的心肺功能[OR=1.04;95% CI:1.01,1.08]和大学或更高的教育程度[OR=1.47;95% CI:1.1,2.00]也与出现 AWS 的几率较高有关。研究结果突出表明,有必要提高人们对 AWS 的认识,以便在术后早期及早发现并进行物理治疗干预。
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Axillary Web Syndrome in Newly Diagnosed Individuals after Surgery for Breast Cancer: Baseline Results from the AMBER Cohort Study
To examine potential associations between post-surgical axillary web syndrome (AWS) and demographic, medical, surgical, and health-related fitness variables in newly diagnosed individuals with breast cancer. Participants were recruited between 2012 and 2019. Objective measures of health-related fitness, body composition, shoulder range of motion (ROM) and function, and AWS were performed within 3 months of breast cancer surgery. AWS was identified in 243 (17.3%) participants and was associated with poorer shoulder ROM and function, and higher pain compared with women without AWS. Multivariable logistic regression analysis identified axillary lymph node dissection versus sentinel lymph node biopsy [OR = 3.97; 95% CI: 2.62, 6.03], mastectomy versus breast-conserving surgery [OR = 1.60, 95% CI: 1.17, 2.19], lower versus higher total percentage body fat [OR = 1.60; 95% CI: 1.10, 2.34], and earlier versus later time from surgery [OR: 1.56; 95% CI: 1.10, 2.23] as significantly associated with a higher odds of AWS. Higher cardiorespiratory fitness [OR =1.04; 95% CI: 1.01, 1.08] and university or higher education [OR = 1.47; 95% CI: 1.1, 2.00] were also associated with higher odds of presenting with AWS. Findings highlight the need for increased awareness of AWS to facilitate early detection and physiotherapy intervention in the early post-surgical period.
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