Shoulder movement after the treatment of early stage breast cancer.

At 18 months after surgery and post-operative radiotherapy, the function of the ipsilateral shoulder joint was assessed both subjectively and objectively in 141 patients with early stage breast cancer. Half of the patients said that function was reduced compared with before (any) treatment. Overall, 48% had measured limitation of at least one shoulder movement. Mastectomy patients had more problems than those who had a wide local excision (79% versus 35%) as did those (node positive patients) who had axillary irradiation (73%) compared with those who did not (35%). Patients with dysfunction of shoulder movement before radiotherapy had a 60% chance of persistent movement problems at 18 months, compared with 24% of those with normal postoperative function. Informal exercise did not appear to have had any impact on the development of movement limitation.