Impact of sentinel lymph node biopsy versus axillary lymph node dissection on shoulder range of motion in early rehabilitation after breast cancer surgery.

BACKGROUND

The impact of early rehabilitation on shoulder range of motion (ROM) limitation following sentinel lymph node biopsy (SLNB) in breast cancer surgery remains insufficiently understood. This study evaluated postoperative changes in shoulder ROM by surgical procedure among patients with breast cancer who underwent early rehabilitation.

METHODS

This retrospective study included patients with breast cancer who underwent total mastectomy with SLNB (n = 149) or axillary lymph node dissection (ALND) (n = 55). Rehabilitation commenced on postoperative day 1. Shoulder ROM was assessed preoperatively, immediately postoperatively, and at the end of outpatient rehabilitation.

RESULTS

Preoperative ROM did not differ between groups. Both groups showed significant postoperative declines (p < 0.05). After rehabilitation, flexion and abduction improved significantly in both groups (p < 0.05). In the SLNB group, median flexion increased from 122.5° to 140°, abduction from 112.5° to 155.3°, and horizontal abduction from 12.5° to 25°. In the ALND group, flexion improved from 120° to 150°, abduction from 115° to 155°, and horizontal abduction from 10° to 20°. Although the SLNB group required fewer outpatient rehabilitation days (mean 36.6 vs. 45.9), final shoulder ROM was comparable between groups, with no significant differences at the end of rehabilitation.

CONCLUSIONS

SLNB was associated with less severe postoperative shoulder ROM limitation than ALND, indicating that early rehabilitation may allow a more rapid recovery of ROM in SLNB patients.