DOI QR코드

DOI QR Code

유방암 수술 후 동일측 유착관절낭염에 대한 관절강내 주사 치료의 안전성 및 효과

Safety and Effectiveness of Intra-articular Injection on the Ipsilateral Adhesive Capsulitis after Breast Cancer Surgery

  • 조미경 (부산대학교병원 재활의학과 및 의생명연구원) ;
  • 김동민 (부산대학교병원 재활의학과 및 의생명연구원) ;
  • 김영모 (부산대학교병원 재활의학과 및 의생명연구원) ;
  • 양태웅 (부산대학교병원 재활의학과 및 의생명연구원) ;
  • 윤진아 (부산대학교병원 재활의학과 및 의생명연구원) ;
  • 이병주 (부산대학교병원 재활의학과 및 의생명연구원)
  • Cho, Mi Kyung (Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Dong Min (Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Young Mo (Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Yang, Tae-Woong (Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Yoon, Jin-A (Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Lee, Byeong-Ju (Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital)
  • 투고 : 2021.09.16
  • 심사 : 2021.10.26
  • 발행 : 2021.12.31

초록

Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.

키워드

참고문헌

  1. Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Pineros M, Znaor A, et al. Cancer statistics for the year 2020: An overview. Int J Cancer 2021. 2021;10.1002/ijc.33588.
  2. Cho CH, Lee KL, Cho J, Kim D. The incidence and risk factors of frozen shoulder in patients with breast cancer surgery. Breast J 2020;26:825-8. https://doi.org/10.1111/tbj.13610
  3. Kim JH, Kim SH, Kim HR, Lee SH, Yoon SY, Yang JH, et al. Ultrasonographic evaluation of chronic shoulder pain after breast cancer surgery: single center, cross-sectional study. Sci Rep 2020;10:1-8. https://doi.org/10.1038/s41598-019-56847-4
  4. Yang S, Park DH, Ahn SH, Kim J, Lee JW, Han JY, et al. Prevalence and risk factors of adhesive capsulitis of the shoulder after breast cancer treatment. SupportCare Cancer 2017;25:1317-22.
  5. Ferguson CM, Swaroop MN, Horick N, Skolny MN, Miller CL, Jammallo LS, et al. Impact of ipsilateral blood draws, injections, blood pressure measurements, and air travel on the risk of lymphedema for patients treated for breast cancer. J Clin Oncol 2016;34:691-8. https://doi.org/10.1200/JCO.2015.61.5948
  6. Favejee M, Huisstede B, Koes B. Frozen shoulder: the effectiveness of conservative and surgical interventions-systematic review. Br J Sports Med 2011;45:49-56. https://doi.org/10.1136/bjsm.2010.071431
  7. Kang SY, Kim YS, Kim Z, Kim HY, Kim HJ, Park S, et al. Breast cancer statistics in Korea in 2017: data from a breast cancer registry. J Breast Cancer 2020;23:115-28. https://doi.org/10.4048/jbc.2020.23.e24
  8. Smoot B, Paul SM, Aouizerat BE, Dunn L, Elboim C, Schmidt B, et al. Predictors of altered upper extremity function during the first year after breast cancer treatment. AmJ Phys Med Rehabil 2016;95:639-55. https://doi.org/10.1097/PHM.0000000000000455
  9. Ebaugh D, Spinelli B, Schmitz KH. Shoulder impairments and their association with symptomatic rotator cuff disease in breast cancer survivors. Med Hypotheses 2011;77:481-7. https://doi.org/10.1016/j.mehy.2011.06.015
  10. National Lymphedema Network. Position statement of the National Lymphedema Network: [Internet]. New York (NY): National Lymphedema Network c2012 [cited 2021 Mar 1]. Available from:https://klosetraining.com/wp-content/uploads/2015/05/NLNpractices.pdf.
  11. Asdourian MS, Skolny MN, Brunelle C, Seward CE, Salama L, Taghian AG. Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis. Lancet Oncol 2016;17:e392-405. https://doi.org/10.1016/S1470-2045(16)30204-2
  12. De Groef A, Van Kampen M, Dieltjens E, Christiaens M-R, Neven P, Geraerts I, et al. Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review. Arch Phys Med Rehabil 2015;96:1140-53. https://doi.org/10.1016/j.apmr.2015.01.006
  13. Leonidou A, Woods D. A preliminary study of manipulation under anaesthesia for secondary frozen shoulder following breast cancer treatment. Ann R Coll Surg Engl 2014;96:111-5. https://doi.org/10.1308/003588414X13824511649652
  14. Ghaffar NAA, Ghanem MA. Combined Platelet Rich Plasma Intra-articular Shoulder Injection and Stellate Ganglion block, A new Technique for Management of Chronic Post-mastectomy Shoulder Pain Syndrome: A randomized Controlled Trial. Sri Lankan J Anaesthesiol 2019;27:133-8. https://doi.org/10.4038/slja.v27i2.8416
  15. de Witte PB, Selten JW, Navas A, Nagels J, Visser CP, Nelissen RG, et al. Calcific tendinitis of the rotator cuff: a randomized controlled trial of ultrasound-guided needling and lavage versus subacromial corticosteroids. Am J Sports Med 2013;41:1665-73. https://doi.org/10.1177/0363546513487066