A.I. BURNASYAN FMBC CLINICAL BULLETIN

ISSN 2782-6430 (print)

State Research Center −Burnasyan Federal Medical Biophysical
Center of Federal Medical Biological Agency

The journal is published in Russian.
Format – A4.
The periodicity of the journal is 4 times a year.

Issue №2 2025 год

A.I. Burnasyan  FMBC clinical bulletin. 2025 № 2

K.I. Medvedev, A.A. Zavialov

Functional Disorders after Mastectomy. Methods for Their Correction

International Office, State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russiа

Contact person: Medvedev Kirill Igorevich: kirillme11@yandex.ru

Abstract
In 2023, more than 70,000 cases of breast cancer were detected in the Russian Federation, and there are more than 794,000 patients registered at the dispensary. Surgical treatment is widely used as a standalone treatment or as part of a combined treatment in almost all stages of the cancer process. Various types of breast-conserving surgeries, including unilateral and bilateral mastectomy, are actively performed, followed by immediate or delayed reconstruction.

However, a significant disadvantage of these surgeries is the occurrence of functional disorders in anatomical and physiological functions that can lead to psychological issues and a decline in patients’ quality of life.

Statistical data indicate a high prevalence of functional disorders that can occur after mastectomy. To develop individual and personalized methods for complex rehabilitation, it is necessary to have a better understanding of these problems. This requires both non-medical and medical approaches. A multicomponent approach can effectively address the physical, psychological, and functional issues faced by patients, improving their quality of life.

This review provides materials that can help us better understand neuromuscular syndromes and functional disorders associated with musculoskeletal damage after mastectomy.

Keywords: breast cancer, mastectomy, functional disorders, postmastectomy syndrome,  methods for correction

For citation: Medvedev K.I., Zavialov A. A. Functional Disorders after Mastectomy. Methods for Their Correction. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2025.2:59-64. (In Russian) DOI: 10.33266/2782-6430-2025-2-59-64

 

REFERENCES

  1. Злокачественные новообразования в России в 2023 году (заболеваемость и смертность) / Под ред. А.Д.Каприна и др. М.: МНИОИ им. П.А. Герцена − филиал «НМИЦ радиологии», 2024. 276 с. [Zlokachestvennyye Novoobrazovaniya v Rossii v 2023 Godu (Zabolevayemost’ i Smertnost’) = Malignant Neoplasms in Russia in 2023 (Incidence and Mortality). Ed. A.D. Kaprin, et al. Moscow, MNIOI im. P.A. Gertsena − Filial «NMITS Radiologii» Publ., 2024. 276 p. (In Russ.)]. ISBN 978-5-85502-298-8.
  2. Lovelace D.L., McDaniel L.R., Golden D. Long-Term Effects of Breast Cancer Surgery, Treatment, and Survivor Care. J Midwifery Womens Health. 2019;64;6:713-724. doi: 10.1111/jmwh.13012.
  3. Fefferman M., Nicholson K., Kuchta K., Pesce C., Kopkash K., Yao K. Rates of Bilateral Mastectomy in Patients with Early-Stage Breast Cancer. JAMA Netw Open. 2023;6;1:e2251348. doi: 10.1001/jamanetworkopen.2022.51348.
  4. Admoun C., Mayrovitz H. Choosing Mastectomy vs. Lumpectomy-with-Radiation: Experiences of Breast Cancer Survivors. Cureus. 2021;13;10:e18433. doi: 10.7759/cureus.18433.
  5. Vidt M.E., Potochny J., Dodge D., et al. The Influence of Mastectomy and Reconstruction on Residual Upper Limb Function in Breast Cancer Survivors. Breast Cancer Res Treat. 2020;182;3:531–541. doi: 10.1007/s10549-020-05717-z.
  6. Chang P.J., Asher A., Smith S.R. A Targeted Approach to Post-Mastectomy Pain and Persistent Pain Following Breast Cancer Treatment. Cancers (Basel) 2021;13;20:5191. doi: 10.3390/cancers13205191.
  7. Abdo J., Ortman H., Rodriguez N., Tillman R., Riordan E.O., Seydel A. Quality of Life Issues Following Breast Cancer Treatment. Surg Clin North Am. 2023 Feb;103;1:155-167. doi: 10.1016/j.suc.2022.08.014.
  8. Zhou R., Chen Z., Zhang S., Wang Y., Zhang C., Lv Y., Yu L. Effects of Exercise on Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Life (Basel). 2024 Aug 14;14;8:1011. doi: 10.3390/life14081011.
  9. Leonardis J.M., Lulic-Kuryllo T., Lipps D.B. The Impact of Local Therapies for Breast Cancer on Shoulder Muscle Health and Function. Crit Rev Oncol Hematol. 2022;177:103759. doi: 10.1016/j.critrevonc.2022.103759.
  10. Wood K.M. Intercostobrachial Nerve Entrapment Syndrome. South Med J. 1978 Jun;71;6:662-3. doi: 10.1097/00007611-197806000-00016. PMID: 663696.
  11. Сouceiro T.C., Valenca M.M., Raposo M.C., et al. Prevalence of Post-Mastectomy Pain Syndrome and Associated Risk Factors: a Cross-Sectional Cohort Study. Pain Manag Nurs 2014;15:731-7.
  12. Marco E., Trépanier G., Chang E., Mauti E., Jones J.M., Zhong T. Postmastectomy Functional Impairments. Curr Oncol Rep. 2023 Dec;25;12:1445-1453. doi: 10.1007/s11912-023-01474-6. Epub 2023 Nov 13. Erratum in: Curr Oncol Rep. 2023 Dec;25;12:1455. doi: 10.1007/s11912-023-01481-7. PMID: 37955831. PMCID: PMC10728246
  13. Wang L., Guyatt G.H., Kennedy S.A., Romerosa B., Kwon H.Y., Kaushal A., Chang Y., Craigie S., de Almeida C.P.B, Couban R.J., Parascandalo S.R., Izhar Z., Reid S., Khan J.S., McGillion M., Busse J.W. Predictors of Persistent Pain after Breast Cancer Surgery: a Systematic Review and Meta-Analysis of Observational Studies. CMAJ. 2016 Oct 4;188;14:E352-E361. doi: 10.1503/cmaj.151276. Epub 2016 Jul 11. PMID: 27402075. PMCID: PMC5047835.
  14. Gong Y., Tan Q., Qin Q., Wei C. Prevalence of Postmastectomy Pain Syndrome and Associated Risk Factors: A Large Single-Institution Cohort Study. Medicine (Baltimore). 2020 May;99;20:e19834. doi: 10.1097/MD.0000000000019834. PMID: 32443289. PMCID: PMC7253604.
  15. Tait R.C., Zoberi K., Ferguson M., Levenhagen K., Luebbert R.A., Rowland K., Salsich G.B., Herndon C. Persistent Post-Mastectomy Pain: Risk Factors and Current Approaches to Treatment. J Pain. 2018 Dec;19;12:1367-1383. doi: 10.1016/j.jpain.2018.06.002. Epub 2018 Jun 30. PMID: 29966772. PMCID: PMC6530598.
  16. Kannan P., Lam H.Y., Ma T.K., Lo C.N., Mui T.Y., Tang W.Y. Efficacy of Physical Therapy Interventions on Quality of Life and Upper Quadrant Pain Severity in Women with Post-Mastectomy Pain Syndrome: a Systematic Review and Meta-Analysis. Qual Life Res. 2022 Apr;31;4:951-973. doi: 10.1007/s11136-021-02926-x. Epub 2021 Jun 29. Erratum in: Qual Life Res. 2022 Apr;31;4:975-976. doi: 10.1007/s11136-022-03104-3. PMID: 34185226. PMCID: PMC8960660.
  17. Ebid A.A., El-Sodany A.M. Long-Term Effect of Pulsed High-Intensity Laser Therapy in the Treatment of Post-Mastectomy Pain Syndrome: a Double Blind, Placebo-Control, Randomized Study. Lasers Med Sci. 2015;30:1747–1755. doi: 10.1007/s10103-015-1780-z
  18. Chappell A.G., Yuksel S., Sasson D.C., Wescott A.B., Connor L.M., Ellis M.F. Post-Mastectomy Pain Syndrome: an Up-to-Date Review of Treatment Outcomes. JPRAS Open. 2021 Aug 11;30:97-109. doi: 10.1016/j.jpra.2021.07.006. PMID: 34522756. PMCID: PMC8426165.
  19. Viscione E.A.R., Weyandt L. A Systematic Review of Phantom Breast Pain/Sensation in Breast Cancer Patients Postmastectomy. NWH. 2022;27;1:25–30. doi: 10.1016/j.nwh.2022.09.009.
  20. Ramesh, Shukla N.K., Bhatnagar S. Phantom Breast Syndrome. Indian J Palliat Care. 2009 Jul;15;2:103-7. doi: 10.4103/0973-1075.58453. PMID: 20668586. PMCID: PMC2902108.
  21. Divella M., Vetrugno L., Bertozzi S., Seriau L., Cedolini C., Bove T. Patient-Reported Pain and other Symptoms Among Breast Cancer Survivors: Prevalence and Risk Factors. Tumori. 2020;106;6:480–490. doi: 10.1177/0300891620908930.
  22. Brennstuhl M.J., Tarquinio C., Montel S., Masson J., Bassan F., Tarquinio P. Using Eye Movement Desensitization and Reprocessing (EMDR) as a Treatment for Phantom Breast Syndrome: Case Study. Sexologies. 2015;24;2:e29–e36. doi: 10.1016/j.sexol.2014.09.004.
  23. Ilfeld B.M., Madison S.J., Suresh P.J., Sandhu N.S., Kormylo N.J., Malhotra N., Loland V.J., Wallace M.S., Mascha E.J., Xu Z., Wen C.H., Morgan A.C., Wallace A.M. Persistent Postmastectomy Pain and Pain-Related Physical and Emotional Functioning with and without a Continuous Paravertebral Nerve Block: a Prospective 1-Year Follow-Up Assessment of a Randomized, Triple-Masked, Placebo-Controlled Study. Ann Surg Oncol. 2015;22;6:2017-25. doi: 10.1245/s10434-014-4248-7. Epub 2014 Nov 21. PMID: 25413267.
  24. Stubblefield M.D., Keole N. Upper Body Pain and Functional Disorders in Patients with Breast Cancer. PM R. 2014;6;2:170–183. doi: 10.1016/j.pmrj.2013.08.605.
  25. Peled A.W., Peled Z.M. Sensory Reinnervation after Mastectomy with Implant-Based Reconstruction. Ann Breast Surg. 2022;6:27. doi: 10.21037/abs-21-9.
  26. Обманов И.В., Ярыгин М.Л., Шмырев В.И., Носенко Е.М., Ярыгин Л.М. Неврологические аспекты хирургического лечения больных раком молочной железы // Российский онкологический журнал. 2014. Т.19. №1. С. 8-12 [Obmanov I.V., Yarygin M.L., Shmyrev V.I., Nosenko Ye.M., Yarygin L.M. Neurological Aspects of Surgical Treatment of Patients with Breast Cancer. Rossiyskiy Onkologicheskiy Zhurnal = Russian Journal of Oncology. 2014;19;1:8-12 (In Russ.)].
  27. Peled A.W., Peled Z.M. Nerve Preservation and Allografting for Sensory Innervation Following Immediate Implant Breast Reconstruction. Plast Reconstr Surg Glob Open. 2019 Jul 24;7;7:e2332. doi: 10.1097/GOX.0000000000002332. PMID: 31942359. PMCID: PMC6952160.
  28. Девликамова Ф.И., Хабиров Ф.А. Миофасциальный болевой синдром: практическое развитие теоретических оснований // Российский журнал боли. 2020. Т.18. №3. С.39 47 [Devlikamova F.I., Khabirov F.A. Myofascial Pain Syndrome: Practical Development of Theoretical Foundations. Rossiyskiy Zhurnal Boli = Russian Journal of Pain. 2020;18;3:39 47 (In Russ.)]. doi: 10.17116/pain20201803139.
  29. Kalichman L., Menahem I., Treger I. Myofascial Component of Cancer Pain Review. J Bodyw Mov Ther. 2019 Apr;23;2:311-315. doi: 10.1016/j.jbmt.2019.02.011. Epub 2019 Feb 15. PMID: 31103113.
  30. Fernández-Lao C., Cantarero-Villanueva I., Fernández-de-Las-Peñas C., Del-Moral-Ávila R., Menjón-Beltrán S., Arroyo-Morales M. Development of Active Myofascial Trigger Points in Neck and Shoulder Musculature is Similar after Lumpectomy or Mastectomy Surgery for Breast Cancer. J Bodyw Mov Ther. 2012 Apr;16;2:183-90. doi: 10.1016/j.jbmt.2011.01.022. Epub 2011 Feb 26. PMID: 22464115.
  31. Fernández-Lao C., Cantarero-Villanueva I., Fernández-de-Las-Peñas C., Del Moral-Ávila R., Castro-Sánchez A.M., Arroyo-Morales M. Effectiveness of a Multidimensional Physical Therapy Program on Pain, Pressure Hypersensitivity, and Trigger Points in Breast Cancer Survivors: a Randomized Controlled Clinical Trial. Clin J Pain. 2012 Feb;28;2:113-21. doi: 10.1097/AJP.0b013e318225dc02. PMID: 21705873.
  32. Lin S.Y., Neoh C.A., Huang Y.T., et al. Educational Program for Myofascial Pain Syndrome. J Altern Complement Med. 2010;16;6:633–40.
  33. Farina S., Casarotto M., Benelle M., et al. A Randomized Controlled Study on the Effect of Two Different Treatments (FREMS AND TENS) in Myofascial Pain Syndrome. Eura Medicophys 2004;40;4:293-301.
  34. Gam A.N., Warming S., Larsen L.H., et al. Treatment of Myofascial Trigger-Points with Ultrasound Combined with Massage and Exercise – a Randomised Controlled Trial. Pain 1998;77;1:73–9
  35. Borg-Stein J., Iaccarino M.A. Myofascial Pain Syndrome Treatments. Phys Med Rehabil Clin N Am. 2014 May;25;2:357-74. doi: 10.1016/j.pmr.2014.01.012. Epub 2014 Mar 17. PMID: 24787338.
  36. Cho C.H., Lee K.L., Cho J., Kim D. The Incidence and Risk Factors of Frozen Shoulder in Patients with Breast Cancer Surgery. Breast J. 2020 Apr;26;4:825-828. doi: 10.1111/tbj.13610. Epub 2019 Sep 6. PMID: 31493310.
  37. Lee T.S., Kilbreath S.L., Refshauge K.M., Herbert R.D., Beith J.M. Prognosis of the Upper Limb Following Surgery and Radiation for Breast Cancer. Breast Cancer Res Treat. 2008;110:19-37.
  38. Ramirez J. Adhesive Capsulitis: Diagnosis and Management. Am Fam Physician. 2019 Mar 1;99;5:297-300. PMID: 30811157.
  39. Yang S., Park D.H., Ahn S.H., Kim J., Lee J.W., Han J.Y., Kim D.K., Jeon J.Y., Choi K.H., Kim W. Prevalence and Risk Factors of Adhesive Capsulitis of the Shoulder after Breast Cancer Treatment. Support Care Cancer. 2017 Apr;25;4:1317-1322. doi: 10.1007/s00520-016-3532-4. Epub 2016 Dec 9. PMID: 27942856.
  40. Challoumas D., Biddle M., McLean M., Millar N.L. Comparison of Treatments for Frozen Shoulder: a Systematic Review and Meta-Analysis. JAMA Netw Open. 2020 Dec 1;3;12:e2029581. doi: 10.1001/jamanetworkopen.2020.29581. PMID: 33326025. PMCID: PMC7745103.
  41. Haider S.I., Awais M.Z., Iqbal M.T. Role of Platelet-Rich Plasma in the Treatment of Adhesive Capsulitis: A Prospective Cohort Study. Cureus. 2022 Oct 21;14;10:e30542. doi: 10.7759/cureus.30542. PMID: 36420240. PMCID: PMC9678237.
  42. Page M.J., Green S., Kramer S., Johnston R.V., McBain B., Buchbinder R. Electrotherapy Modalities for Adhesive Capsulitis (Frozen Shoulder). Cochrane Database Syst Rev. 2014 Oct 1;2014;10:CD011324. doi: 10.1002/14651858.CD011324. PMID: 25271097. PMCID: PMC10898218.
  43. Chen C.Y., Hu C.C., Weng P.W., Huang Y.M., Chiang C.J., Chen C.H., Tsuang Y.H., Yang R.S., Sun J.S., Cheng C.K. Extracorporeal Shockwave Therapy Improves Short-Term Functional Outcomes of Shoulder Adhesive Capsulitis. J Shoulder Elbow Surg. 2014 Dec;23;12:1843-1851. doi: 10.1016/j.jse.2014.08.010. PMID: 25441567.
  44. Pimenta M., Vassalou E.E., Klontzas M.E., Dimitri-Pinheiro S., Ramos I., Karantanas A.H. Ultrasound-Guided Hydrodilatation for Adhesive Capsulitis: Capsule-Preserving Versus Capsule-Rupturing Technique. Skeletal Radiol. 2024 Feb;53;2:253-261. doi: 10.1007/s00256-023-04392-7. Epub 2023 Jul 3. PMID: 37400605. PMCID: PMC10730627.
  45. Yoong P., Duffy S., McKean D., Hujairi N.P., Mansour R., Teh J.L. Targeted Ultrasound-Guided Hydrodilatation Via the Rotator Interval for Adhesive Capsulitis. Skeletal Radiol. 2015 May;44;5:703-8. doi: 10.1007/s00256-014-2047-7. Epub 2014 Nov 21. PMID: 25412709

Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 11.01.2025. Accepted for publication: 15.02.2025

Scroll to Top