The Effects of Radiation Treatment in Breast Cancer Patients on the Subsequent Development of Adhesive Capsulitis

IF 2.7 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2026-08-01 Epub Date: 2026-07-11 DOI:10.1016/j.clbc.2026.07.007

Eujung Park, Seth Eilfer, Katja Klosterman, Stanna Calderon-Tellez, Karina Shah, Rafael Buerba, Anup Shah

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引用次数: 0

Abstract

Background

Adhesive capsulitis (AC) is a disabling condition associated with shoulder pain and restricted range of motion. Although breast cancer treatment has been linked to increased AC risk, the independent contribution of radiation therapy remains unclear.

Patients and Methods

A retrospective cohort study was performed using the PearlDiver MARINER database (2014-2023). Female patients with a primary diagnosis of breast cancer and ≥ 2 years of follow-up were included. Patients with prior shoulder pathology were excluded. Cohorts were stratified by radiation exposure and surgical treatment. Propensity score matching was conducted based on age and Charlson Comorbidity Index (CCI). Outcomes were compared using chi-square tests and odds ratios (ORs).

Results

A total of 1,672,952 patients met inclusion criteria, of whom 22,964 (1.37%) developed AC. Radiation therapy was associated with an increased risk of AC compared with no radiation (OR 1.292, 95% confidence interval 1.251-1.334; P < .001). This association persisted in surgical patients (OR 1.364, P < .001) and across surgical subgroups, including breast-conserving surgery, mastectomy, and mastectomy with reconstruction. Radiation exposure was also associated with increased AC risk in nonsurgical patients (OR 1.172, P < .001).

Conclusion

Radiation therapy is independently associated with an increased risk of adhesive capsulitis following breast cancer diagnosis. These findings underscore the importance of recognizing treatment-related shoulder morbidity and may inform surveillance and early intervention strategies in breast cancer survivorship care.

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乳腺癌放射治疗对粘连性囊炎后续发展的影响。

背景：粘连性囊炎（AC）是一种与肩部疼痛和活动范围受限相关的致残性疾病。尽管乳腺癌治疗与AC风险增加有关，但放射治疗的独立作用尚不清楚。患者和方法：使用PearlDiver MARINER数据库（2014-2023）进行回顾性队列研究。初步诊断为乳腺癌且随访≥2年的女性患者被纳入研究。排除既往有肩关节病变的患者。根据辐射暴露和手术治疗对队列进行分层。根据年龄和Charlson共病指数（CCI）进行倾向评分匹配。结果采用卡方检验和比值比（ORs）进行比较。结果：共有1,672,952例患者符合纳入标准，其中22,964例（1.37%）发生AC。与未接受放射治疗相比，放射治疗与AC风险增加相关（OR为1.292,95%可信区间为1.251-1.334;P < .001）。这种相关性在手术患者中持续存在（OR 1.364, P < 0.001），并在手术亚组中持续存在，包括保乳手术、乳房切除术和乳房切除术重建。辐射暴露也与非手术患者AC风险增加相关（OR 1.172, P < 0.001）。结论：乳腺癌诊断后放射治疗与粘连性囊炎风险增加独立相关。这些发现强调了认识到与治疗相关的肩部发病率的重要性，并可能为乳腺癌生存护理的监测和早期干预策略提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.