A recent retrospective study in Japan highlights significant early reductions in shoulder joint mobility among patients following breast cancer surgery, even when routine inpatient rehabilitation is provided.
Researchers examined factors associated with limited passive shoulder flexion and abduction one month post-surgery, using electronic medical records from a university hospital for patients who completed inpatient rehabilitation between May 2014 and April 2020.
The study included 258 patients, with variables such as age, affected side, body mass index, axillary lymph node removal, type of mastectomy, chemotherapy, radiation therapy, postoperative drain duration, and length of hospital stay. Shoulder range of motion (ROM) was measured before surgery and again at one month postoperatively. Multivariable logistic regression was used to identify predictors of ROM limitation.
Results revealed that 210 patients (81.4%) experienced reduced shoulder mobility at one month. On average, shoulder flexion decreased by 31.3°, and abduction by 35.9°, indicating substantial early restriction even under structured rehabilitation protocols.
Three factors were significantly associated with postoperative ROM limitation: older age, total mastectomy, and a higher number of axillary lymph nodes removed. Recognizing these risk factors can help clinicians anticipate which patients may experience meaningful functional restrictions in the first month after surgery.
For rehabilitation planning, these findings underscore the importance of tailored interventions. Patients who are older or undergo more extensive surgery may benefit from closer monitoring, early goal-setting, and individualized rehabilitation strategies to support recovery and maintain independence in daily activities such as dressing, grooming, and overhead reaching.
