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01-06-2014 | Original Article

Incidence, predictive factors, and prognosis for winged scapula in breast cancer patients after axillary dissection

Authors: Luiz Felipe Nevola Teixeira, Visnu Lohsiriwat, Mario Casales Schorr, Alberto Luini, Viviana Galimberti, Mario Rietjens, Cristina Garusi, Sara Gandini, Luis Otavio Zanatta Sarian, Fabio Sandrin, Maria Claudia Simoncini, Paolo Veronesi

Published in: Supportive Care in Cancer | Issue 6/2014

Abstract

Purpose

Axillary lymph node dissection is part of breast cancer surgery, and winged scapula is a possible sequela. Data regarding its incidence, predictive factors, and patient prognosis remains inconsistent. Ignorance of its diagnosis may lead to undertreatment with physical morbidity.

Methods

Breast cancer patients with axillary lymph node dissection were prospectively recruited. Postoperative examinations by the physiotherapy staff were performed.

Results

One hundred eighty-seven patients were recruited during July-October 2012; 51 patients had a positive diagnosis (27.2 %), with 38 patients (86 %) who recovered completely from the winged scapula, while 6 patients (13 %) still had winged scapula at 6 months after surgery. One hundred thirty patients underwent mastectomy and 100 cases had immediate reconstruction. Age, BMI, previous shoulder joint morbidity, and breast surgery were not associated with winged scapula. Neoadjuvant treatment, mastectomy or conservative surgery, immediate reconstruction, tumor size, and nodal involvement also did not show any correlation. Breast reconstruction with prosthesis, even with serratus muscle dissection, does not increase the incidence of winged scapula.

Conclusion

Winged scapula is not an uncommon incidence after breast cancer surgery. Physiotherapy is related to the complete recovery. The severity or grading of the winged scapula and the recovery time after physiotherapy should be investigated in the future studies.

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Title: Incidence, predictive factors, and prognosis for winged scapula in breast cancer patients after axillary dissection
Authors: Luiz Felipe Nevola Teixeira
Visnu Lohsiriwat
Mario Casales Schorr
Alberto Luini
Viviana Galimberti
Mario Rietjens
Cristina Garusi
Sara Gandini
Luis Otavio Zanatta Sarian
Fabio Sandrin
Maria Claudia Simoncini
Paolo Veronesi
Publication date: 01-06-2014
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 6/2014
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-014-2125-3

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