乳癌術後之上肢問題的醫學新知與物理治療

Axillary lymph node dissection (ALND) has traditionally been the gold standard for staging the axilla in patients with breast cancer, and a predictor for recurrent and survival rate. Besides the well-known complications of shoulder dysfunction and lymphedema, other shoulder-arm problems following ALND such as post breast therapy pain syndrome, axillary web syndrome, and seroma have been successively documented. These shoulder-arm problems may interfere with the activities of daily life and quality of life of patients after breast cancer surgery. In this article, we reviewed the possible risk factors, patholophysiology, incidence, and clinical features for each shoulder-arm problem after breast cancer surgery, and identified the relationships among pathology, impairment, and functional limitations based on a disablement process model. The role of physical therapists, actively to prevent and treat the development of pain and loss of arm function, was also discussed.