Clinical Course of Metastatic Brachial Plexopathy in Patients With Breast Cancer

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.apmr.2025.01.076

So Ra Han, Jae Yong Jeon

{"title":"Clinical Course of Metastatic Brachial Plexopathy in Patients With Breast Cancer","authors":"So Ra Han, Jae Yong Jeon","doi":"10.1016/j.apmr.2025.01.076","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To track the clinical courses of metastatic brachial plexopathy (MBP) in patients with breast cancer. MBP is a late complication of breast cancer that results in significant functional impairments such as pain and muscle weakness. However, there have been exceedingly rare studies of MBP that are limited to breast cancer or tracking the clinical course of MBP.</div></div><div><h3>Design</h3><div>This study retrospectively reviewed medical records of breast cancer patients with confirmed MBP who visited the Department of Rehabilitation Medicine at Seoul Asan Medical Center from January 2009 to September 2023.</div></div><div><h3>Setting</h3><div>This study retrospectively reviewed medical records of breast cancer patients with confirmed MBP who visited the Department of Rehabilitation Medicine at Seoul Asan Medical Center from January 2009 to September 2023.</div></div><div><h3>Participants</h3><div>A total of 29 participants (N=29) available with over 1 year of follow-up data were ultimately selected.</div></div><div><h3>Interventions</h3><div>Data on demographic, breast cancer–related, and MBP-related characteristics were collected.</div></div><div><h3>Main Outcome Measures</h3><div>Changes in clinical symptoms were investigated at both 1-year and 2-year follow-up timepoints.</div></div><div><h3>Results</h3><div>Of the total 29 subjects, the mean age was 54.3±11.6 years, and the duration from breast cancer diagnosis to the MBP diagnosis averaged 7.3±7.2 years. At the time of MBP diagnosis, accompanying symptoms included upper limb muscle weakness (96.0%), pain (82.8%), shoulder joint limited range of motion (LROM) (47.8%), and malignant lymphedema (58.3%). Among those experiencing pain, 91.6% reported moderate to severe pain. All participants with shoulder LROM showed limited abduction. Regarding clinical course follow-up, upper limb weakness displayed diverse courses at 1-year and remained relatively stable at 2-year. In the case of pain, most participants showed no significant changes at 1 year (21 out of 28), but a tendency toward maintenance or worsening was noted at 2 years (13 out of 14). Shoulder LROM remained stable or worsened at 1 year (18 out of 22), with no significant changes observed at 2-year follow-up. All participants with lymphedema, except one, received rehabilitation therapy and most of them showed either improvement or maintenance (16 out of 19) at 1 year. This tendency persisted at 2-year follow-up.</div></div><div><h3>Conclusions</h3><div>This study comprehensively analyzed the clinical courses of various symptoms accompanying breast cancer MBP. Our findings are expected to ultimately contribute to understand and predict the course of individual breast cancer MBP patients in future clinical practice.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Pages e29-e30"},"PeriodicalIF":3.6000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0003999325001029","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

To track the clinical courses of metastatic brachial plexopathy (MBP) in patients with breast cancer. MBP is a late complication of breast cancer that results in significant functional impairments such as pain and muscle weakness. However, there have been exceedingly rare studies of MBP that are limited to breast cancer or tracking the clinical course of MBP.

Design

This study retrospectively reviewed medical records of breast cancer patients with confirmed MBP who visited the Department of Rehabilitation Medicine at Seoul Asan Medical Center from January 2009 to September 2023.

Setting

Participants

A total of 29 participants (N=29) available with over 1 year of follow-up data were ultimately selected.

Interventions

Data on demographic, breast cancer–related, and MBP-related characteristics were collected.

Main Outcome Measures

Changes in clinical symptoms were investigated at both 1-year and 2-year follow-up timepoints.

Results

Of the total 29 subjects, the mean age was 54.3±11.6 years, and the duration from breast cancer diagnosis to the MBP diagnosis averaged 7.3±7.2 years. At the time of MBP diagnosis, accompanying symptoms included upper limb muscle weakness (96.0%), pain (82.8%), shoulder joint limited range of motion (LROM) (47.8%), and malignant lymphedema (58.3%). Among those experiencing pain, 91.6% reported moderate to severe pain. All participants with shoulder LROM showed limited abduction. Regarding clinical course follow-up, upper limb weakness displayed diverse courses at 1-year and remained relatively stable at 2-year. In the case of pain, most participants showed no significant changes at 1 year (21 out of 28), but a tendency toward maintenance or worsening was noted at 2 years (13 out of 14). Shoulder LROM remained stable or worsened at 1 year (18 out of 22), with no significant changes observed at 2-year follow-up. All participants with lymphedema, except one, received rehabilitation therapy and most of them showed either improvement or maintenance (16 out of 19) at 1 year. This tendency persisted at 2-year follow-up.

Conclusions

This study comprehensively analyzed the clinical courses of various symptoms accompanying breast cancer MBP. Our findings are expected to ultimately contribute to understand and predict the course of individual breast cancer MBP patients in future clinical practice.

Disclosures

none.

查看原文本刊更多论文

乳腺癌患者转移性臂丛病的临床病程

目的探讨乳腺癌转移性臂丛病（MBP）的临床病程。MBP是乳腺癌的晚期并发症，可导致明显的功能障碍，如疼痛和肌肉无力。然而，很少有关于MBP的研究局限于乳腺癌或追踪MBP的临床过程。本研究回顾性分析了2009年1月至2023年9月在首尔峨山医疗中心康复医学科就诊的确诊MBP乳腺癌患者的病历。本研究回顾性分析了2009年1月至2023年9月在首尔峨山医疗中心康复医学科就诊的确诊MBP乳腺癌患者的医疗记录。最终选择随访数据超过1年的29名参与者（N=29）。干预措施收集了人口统计学、乳腺癌相关和mbp相关特征的数据。在1年和2年随访时间点调查临床症状的变化。结果29例患者的平均年龄为54.3±11.6岁，从乳腺癌诊断到MBP诊断的平均时间为7.3±7.2年。在诊断MBP时，伴随症状包括上肢肌肉无力（96.0%）、疼痛（82.8%）、肩关节活动范围受限（47.8%）和恶性淋巴水肿（58.3%）。在经历疼痛的人中，91.6%的人报告中度到重度疼痛。所有患有肩关节外展的参与者均表现出有限的外展。在临床病程随访中，上肢无力在1年时表现出不同的病程，在2年时保持相对稳定。在疼痛的情况下，大多数参与者在1年内没有明显的变化（28人中有21人），但在2年内有维持或恶化的趋势（14人中有13人）。肩关节LROM在1年时保持稳定或恶化（22例中有18例），在2年随访时未观察到明显变化。除1例外，所有淋巴水肿患者均接受了康复治疗，大多数患者在1年后表现出改善或维持（19例中有16例）。这种趋势在2年随访中持续存在。结论本研究全面分析了乳腺癌MBP伴发各种症状的临床病程。我们的研究结果有望在未来的临床实践中最终有助于理解和预测个体乳腺癌MBP患者的病程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.