Purpose
Breast cancer-related lymphedema (BCRL) is a chronic,
debilitating condition that causes psychosocial problems that affect breast cancer survivors’ daily lives and self-maintenance.
BCRL symptoms include swelling,
heaviness,
tightness,
firmness,
pain/aching/soreness,
numbness,
tingling,
stiffness,
limb fatigue,
limb weakness,
and impaired limb mobility (1-3).
Ultrasound (US) elastography is a non-invasive,
inexpensive,
and useful adjunctive tool that allows the measure tissue stiffness noninvasively.
The aim of this study was to analyze the effects of BCRL on the median nerve stiffness measured by Shear Wave Elastography (SWE) and to...
Methods and Materials
This study conforms to the Declaration of Helsinki. The study was approved by the Institutional Review Board and Ethics Committee and supported by the Institutional Research Fund.
Written informed consent was obtained from all patients.
This prospective study included 15 consecutive patients (mean age,
56.8±3.2 years) with having BCRL(fig.1).
The stiffness of the median nerve was measured by Virtual Touch tissue imaging quantification method (VTIQ; Siemens,
Erlangen,
Germany).
The severity of pain was measured by Visual Analogue Scale (VAS).
The disability score of the affected...
Results
The stiffness of the median nerve on the affected and unaffected sides did not show any significant difference (p ≥0.05).
There was a strong positive correlation with the stiffness of the median nerve and duration of the lymphedema (r =0.93,
p<.05) (Figs.
2 and 3).
The median nerve stiffness showed weak positive correlation with the severity of pain (r =0.34,
p ≥0.05).
There was a moderate positive correlation with the Quick DASH score and the stiffness of the median nerve (r =0.52,
p<.05).
Conclusion
BCRL may cause a compression to the median nerve at carpal tunnel due to soft tissue swelling and increased pressure in the carpal tunnel.
Our study demonstrated a strong positive correlation with the stiffness of the median nerve and duration of the lymphedema
Previously,
chronic flexed wrist posture was shown to cause a decrease in the CSA of the median nerve due to chronic compression after stroke and increase in the stiffness of the median nerve in stroke patients (4).
BCRL may cause soft tissue...
References
1.McLaughlin SA,
Bagaria S,
Gibson T,
et al.
Trends in risk reduction practices for the prevention of lymphedema in the first 12 months after breast cancer surgery.
J Am Coll Surg.
2013;216(3):380–9.
2.Fu MR,
Ridner SH,
Hu SH,
et al.
Psychosocial impact of lymphedema: a systematic review of literature from 2004 to 2011.
Psychooncology.
2013;22(7):1466–84.
3.Fu MR,
Kang Y.
Psychosocial impact of living with cancer-related lymphedema.
Semin Oncol Nurs.
2013;29(1):50–60.
4.
Aslan H,
Analan PD.
Effects of chronic flexed wrist posture on the elasticity and...