Evidence of rotator cuff disease after breast cancer treatment: scapular kinematics of post-mastectomy and post-reconstruction breast cancer survivors

Figures & data

Figure 1. Participant performing an unloaded overhead reach with the left hand.

Figure 2. Interaction plot of scapular kinematics for the pain and no pain groups. Upward rotation values are from the right side, while internal rotation values are from the left side. For the mastectomy group, those with pain had lower upward rotation and higher internal rotation. The opposite pattern was found in the reconstruction group.

Figure 3. Peak right upward rotation (top) and left internal rotation (bottom) presented with reconstruction groups split by surgery types and pain status. Reconstruction types were grouped together for analysis due to small sample sizes for each type. Error bars represent standard deviation. Mastectomy: mastectomy-only; implant: subpectoral implant; DIEP: deep inferior epigastric perforator; LD: latissimus dorsi flap.

Table 1. Participant characteristics [mean (95% CI)] for all five combinations of breast cancer treatment and presence of pain.

	Control	Mastectomy		Reconstruction
		No pain	Pain	No pain	Pain
N	25	12	13	27	18
Age (yrs)	51.6 (49.7, 53.6)	52.9 (50.4,55.4)	55.9 (52.6, 59.1)	52.2 (50.5, 54.0)	47.6 (45.0, 50.2)^b
QuickDASH (/100)	4.7 (2.9, 6.4)	16.9 (12.9,20.9)^a	17.7 (12.5,22.8)^a	14.4 (11.5,17.2)^a	30.0 (25.8,34.1)^ab
Months since last surgery	–	50 (39.5,60.5)	67.3 (53.8,80.8)^c	45.1 (37.7,52.5)	30.9 (20.1,31.3)
Type of reconstruction (I/D/L)	–	–	–	13 I/9 D/5 L	6 I/7 D/5 L
Immediate or delayed (Im/De)	–	–	–	14 Im/13 De	9 Im/9 De
Average length of delay	–	–	–	42.8 (20.0,65.6)	21.8 (11.9,31.6)
Lymph node removal (#/n)	–	8	9	25	17
Radiation (#/n)	–	5	5	13	16
Right Upward rotation (°)	29.1 (26.6, 31.5)	30.7 (26.4, 35.0)	22.9 (19.8, 26.2)^ab	27.4 (25.1, 29.6)	31.2 (28.9, 33.6)
Left Internal Rotation (°)	44.1 (41.5, 46.7)	41.5 (40.3, 42.7)	45.1 (41.3, 48.9)	44.9 (42.6, 47.2)	39.3 (36.5, 42.1)^d

Upward rotation values are for right-side affected shoulders, while internal rotation values are for left-side affected shoulders. Different superscript letters within a row denotes values that are significantly different (p<.05) between groups: a = significantly different from controls; b = significantly different from the other breast cancer groups within the same row; c = significantly different from the reconstruction pain group; d = significantly different from the reconstruction-no pain group.

I: implant; D: DIEP; L: LD; Im: immediate; De: delayed; CI: confidence interval.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [SK], upon reasonable request.