Arm/Shoulder Problems Common After Breast Cancer Surgery

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A study found that most women who had breast cancer surgery had some type of arm problem (ranging from mild to severe) even 1 1/2 years after surgery. The research was presented at the 2008 American Society of Clinical Oncology (ASCO) Breast Cancer Symposium.

After breast cancer surgery, some women experience numbness, swelling, weakness, or tingling in the arm and shoulder area on the same side of the body on which surgery was done. These problems are more likely to happen after mastectomy surgery and less likely to happen after lumpectomy. The possibility for arm and shoulder problems depends quite a bit on whether any lymph nodes were removed during surgery and if so, how many were removed.

Lymphedema (pronounced LIMF-eh-DEE-ma) is a condition that can happen after breast cancer surgery. Research has shown that between 5% and 25% of women develop some lymphedema after breast cancer surgery. Lymphedema is a build-up of lymph fluid in arm tissue, which causes swelling. Edema is the medical term for swelling. Lymph fluid normally drains from body tissue through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or damaged during surgery, lymph fluid doesn't drain properly and collects in the tissue near the surgery site. Lymphedema can cause other symptoms such as tingling, numbness, stiffness, and weakness. Still, those problems can happen after breast cancer surgery even without lymphedema.

The researchers studied more 250 women for 18 months after breast cancer surgery. Every 3 months, the women reported any arm problems and had a physical exam to check for any movement or function problems. The researchers tested upper body strength and endurance, hand grip, flexibility, and range of motion.

The results:

  • Numbness and swelling were the most common symptoms, both at 6 months and 18 months after surgery. Other problems reported or seen in at least 10% of the women included:
    • pain
    • tingling
    • weakness
    • stiffness
    • poor range of motion
  • Most women with arm problems had more than one symptom.
  • Six months after surgery, 85% of the women had at least one mild problem. At 18 months after surgery, 75% of the women still had at least one mild problem.
  • Six months after surgery, about half the women had a moderate or severe arm problem. At 18 months after surgery, more than 37% of the women still had a moderate or severe problem.
  • Even if a woman didn't have lymphedema, other arm problems happened after surgery. While more than 65% of the women who developed lymphedema had other problems 6 months after surgery, 44% of the women who didn't have lymphedema still had arm problems 6 months after surgery. Having or not having lymphedema didn't affect the number, severity, or duration of the arm problems.

Many of the women who had arm problems after surgery gradually improved during the 18 months of the study. Still, some surgery-related problems, including lymphedema, can become chronic (come back frequently over a long time period).

Breast cancer surgery side effects can greatly affect your quality of life. In most cases, the side effects are unavoidable and your surgeon will do everything possible to minimize them. But just because the side effects are unavoidable doesn't mean they can't be treated or eased.

If you've had breast cancer surgery and now have arm and shoulder problems, talk to your doctor. While not all problems will go away completely, there are steps you can take to manage them. Depending on your situation, you may want to ask your doctor whether referral to a physical rehabilitation or occupational therapy specialist with experience treating breast cancer surgery side effects makes sense. These specialists have experience with specific treatments and exercises that may improve your situation.

For more information on managing and avoiding lymphedema, visit the Breastcancer.org Lymphedema side effect page.

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