Table 5. Mastectomy as a risk factor for arm morbidity following breast cancer treatments.
| Disability | Author | N | Follow-up | Measure | Comparison/Comments | P-value | OR/RR/HR | CI (95%) | Type of evidence | Evidence level |
|---|---|---|---|---|---|---|---|---|---|---|
| Persistent pain | Nesvold 2008 [48] | 263 | 47 months | British Columbia Cancer Agency in Canada | 0.001 | Prospective study | 2B | |||
| Pereira 2017 [69] | 506 | 12 months | Brief Pain Inventory, Pain Disability Index | Mastectomy with ALND | RR = 2.52 | 1.25–5.11 | Cohort study | 2B | ||
| Hamood 2018 [24] | 410 | 7.4 years | NPRS | With or without chronic pain | 0.005 | OR = 3.54 | 1.46–8.59 | A cross-sectional study of a random sample | 4 | |
| Paresthesia | Zararli 2009 [32] | 299 | Self-report | 0.048 | RR = 2.493 | 1.53–4.05 | Prospective | 2B | ||
| Lymphedema | Hack 2010 [59] | 316 | 24 months | Circumference and the Norman questionnaire | HR = 2.1 | 1.3–3.4 | Prospective study | 2B | ||
| Nesvold 2008 [48] | 263 | 47 months | Volume calculation | 0.02 | OR = 2.94 | 1.2–7.3 | Prospective study | 2B | ||
| Clark 2005 [64] | 251 | 3 years | Tape measure | RR = 2.04 | 1.18–3.54 | Prospective observational study | 2B | |||
| Park 2008 [63] | 450 | 24 months | Tape measure | 0.035 | OR = 7.48 | 2.38–23.85 | Prospective study | 2B | ||
| Ahmed 2011 [71] | 1,287 | Self-report | OR = 1.13 | 0.72–1.77 | Cross-sectional study | 4 | ||||
| Decreased range of motion | Nesvold 2008 [48] | 263 | 47 months | British Columbia Cancer Agency in Canada | 0.04 | OR = 2.75 | 1.37–5.5 | Prospective study | 2B | |
| Kuijer 2021 [17] | 1,037 | 1 year | CARES-SF | 0.02 | OR = 1.8 | Multicenter prospective cohort study | 2B | |||
| Freitas-Silva 2010 [77] | 70 | Goniometer (shoulder internal rotation) | Breast-conserving therapy vs modified radical mastectomy and immediate reconstruction | 0.03 | OR = 7.23 | 1.28–17.1 | Cross-sectional study | 4 | ||
| Basu 2020 [60] | 342 | 37 months | Questionnaire was inspired by the Australian BC Family Study | 0.04 | HR = 1.8 | 1.1–3.4 | Retrospective study | 4 | ||
| Ahmed 2011 [71] | 1,287 | Self-report | OR = 1.24 | 0.95–1.59 | Cross-sectional study | 4 | ||||
| Adhesive capsulitis | Wong 2021 [75] | 135 | Restricted passive ROM in 2 or more planes of movement (Goniometer), with normal radiographic findings | Mastectomy with reconstruction | 0.021 | OR = 3.93 | 1.23–12.63 | Cross-sectional observational study | 4 | |
| Functional disabilities | Hayes 2010 [39] | 287 | 18 months | QuickDASH and the Functional Assessment of Cancer Therapy Breast questionnaire | 0.006 | OR = 1.95 | 0.98–5.21 | Prospective study | 2B |
Abbreviations: N: number; CI: confidence interval; OR: odds ratio ; HR: hazard ratio; RR: relative risk; ALND: axillary lymph node dissection; ROM: range of motion; NPRS: numeric pain rating scale.