Clinical Course of Metastatic Brachial Plexopathy in Patients With Breast Cancer

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

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.

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.