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Detection of early changes in the muscle properties of the pectoralis major in breast cancer patients treated with radiotherapy using a handheld myotonometer

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Abstract

Objective

The primary aim was to investigate serial changes in the mechanical properties of the pectoralis major (PM), upper trapezius (UT), and sternoclavicular mastoid muscle (SCM) in breast cancer patients undergoing radiotherapy (RT) using a hand-held myotonometer. The secondary aims were to determine changes in subjective symptoms and to identify correlation with subjective results.

Design

A total of 42 breast cancer patients were enrolled in this longitudinal prospective study. Muscle properties of the PM, UT, and SCM were evaluated before RT, immediately after RT, and 4 months post-RT. Subjective symptom scales of pain and stiffness at rest/stretch of each muscle were evaluated.

Results

The PM showed significant side-to-side differences; the affected PM showed increased tone, stiffness, and decreased elasticity compared with the unaffected PM. The affected PM and UT showed significant time-dependent interactions. Stiffness of the affected PM at stretching was significantly higher 4 months post-RT than baseline. Only the tone and elasticity of the affected PM were correlated with subjective symptoms.

Conclusion

In breast cancer patients who received RT after surgery, increased tone, stiffness, and decreased elasticity were observed in the affected PM compared with the unaffected side, which sustained four months post-RT. Change in muscle properties immediately after RT preceded subjective stiffness, which worsened significantly 4 months post-RT compared with baseline.

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Abbreviations

PM:

Pectoralis major

UT:

Upper trapezius

SCM:

Sternoclavicular mastoid muscle

RT:

Radiation therapy

BCS:

Breast-conserving surgery

TM:

Total mastectomy

SWE:

Shear wave elastography

MRE:

Magnetic resonance elastography

BMI:

Body mass index

MRI:

magnetic resonance image

EMG:

Electromyography

CT:

Computed tomography

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Acknowledgments

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP) (NRF-2017R1A2B4010795).

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea

    Yoon Kim

  2. Center for Clinical Medicine, Samsung Biomedical Research Institute, Seoul, Republic of Korea

    So Yeon An

  3. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Won Park

  4. Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea

    Ji Hye Hwang

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  1. Yoon Kim
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Correspondence to Ji Hye Hwang.

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Kim, Y., An, S.Y., Park, W. et al. Detection of early changes in the muscle properties of the pectoralis major in breast cancer patients treated with radiotherapy using a handheld myotonometer. Support Care Cancer 29, 2581–2590 (2021). https://doi.org/10.1007/s00520-020-05751-z

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  • DOI: https://doi.org/10.1007/s00520-020-05751-z

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