JSU Student Symposium 2022

Are Breast Cancer Survivors More Susceptible to Shoulder Pathologies than Healthy Individuals? A Critically Appraised Topic


Are Breast Cancer Survivors More Susceptible to Shoulder Pathologies than Healthy Individuals? A Critically Appraised Topic



Faculty Mentor

Jennifer Savage, Kinesiology; Chris Clark, Kinesiology


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Submission Type



11:00-11:10am | Houston Cole Library, 11th Floor


Background - Breast cancer is the most common cancer in the world and is the primary cancer mortality in females around the world. Shoulder and arm morbidity have become significant complications in breast cancer survivors in recent years. Detailed knowledge surrounding upper-limb functional ability is limited in research thus forming the clinical question, are breast cancer survivors more susceptible to shoulder pathologies than healthy individuals?

Methods - A computerized search was completed September 2021. The search terms used were breast cancer survivors, shoulder injuries, shoulder pathologies, shoulder interventions, and upper-limb kinematics. Electronic database used was Google Scholar. Inclusion criteria: Articles that used a control group to compare to breast cancer survivors, research conducted in 2010 or later, and unilateral breast cancer diagnosis. Exclusion criteria: Articles with no control groups, research before 2010, and survivors with bilateral breast cancer. Validity of the selected studies was determined using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Strengthening the Reporting of Observational Studies in Epidemiology, and/or Physiotherapy Evidence Database scale. One author independently reviewed the studies, scored each paper and reviewed the completed appraisals to come to a consensus on study quality.

Results - The literature search retrieved 22 studies and 15 studies were excluded based on exclusion criteria, resulting in seven studies. These seven studies met the inclusion criteria and the level of evidence as suggested by the Strength of Recommendation of Taxonomy used to identify eligible studies. Mafu et al., Giacalone et al., Da Groef et al., and Castro-Martin et al., focused on the role of angiogenesis, therapeutic interventions, and postoperative physical therapy and found radiotherapy and chemotherapy produce a physiological response that starts the angiogenesis process, which results in increased shoulder function in therapeutic interventions. Brookham et al. conducted two different studies, along with Ribeiro et al. focusing on upper-limb kinematics, scapular kinematics, and humeral rotation of the breast cancer population and found muscular compensation, decreased upward rotation of the scapula, shoulder instability, and increased effort contribute to quicker fatigue and decreased functional capacity.

Conclusion - There is strong evidence demonstrating biomechanical factors can play a role in the development of shoulder pathologies in breast cancer survivors. Overall, breast cancer survivors that receive chemotherapy and radiotherapy, can have positive outcomes in shoulder function with the use of therapeutic interventions, and postoperative physical therapy. In addition, breast cancer survivors who have decreased upper-limb kinematics, scapular kinematics, and humeral rotation could show decreased functional capacity of the shoulder. Future research should focus on chemical adaptations in the breast cancer population, as well as long-term therapeutic interventions. As an athletic trainer, it is vital to understand that you will assess and manage a wide variety of patients and injuries/illnesses, which could include breast cancer survivors.


student research, kinesiology


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Are Breast Cancer Survivors More Susceptible to Shoulder Pathologies than Healthy Individuals? A Critically Appraised Topic