Grant: Project Grant

Breast cancer is the most common cancer in Canadian women, with an estimated 1 in 8 affected in their lifetime. Fortunately, the breast cancer survival rate is very high when diagnosed and treated early. Many survivors experience upper limb problems after routine treatment, and these problems may be worsened by breast reconstruction. Kinematics, or body motion, can also be negatively affected by breast cancer treatment, influencing functional abilities and secondary injury risk. Breast reconstructions may have further harmful effects on upper limb movement patterns. Improved definition of this relationship is sorely needed. Therefore, the primary aim of this project is to define upper limb kinematics in breast cancer survivors with and without shoulder pain following one of three types of breast cancer surgical procedures (mastectomy-only and 2 types of reconstructions). We will also examine how other cancer treatment factors, like radiation or lymph node dissection, may influence kinematics, and how patient perceptions of dysfunction are related to kinematic outcomes. Upper limb motion of breast cancer survivors will be measured with optical motion capture while they perform work-related activities (reaches and lifts) and functional (activities of daily living) tasks. Angles of the upper arm and shoulder blade will be compared among groups. Qualitative data will be collected via phone interviews to explore survivors' perceptions of dysfunction. We anticipate that there will be differences in kinematics between the surgery and pain groups that will help us to understand why functional abilities are reduced after breast reconstruction and why survivors are more likely to experience secondary musculoskeletal disorders. Our results will provide critical information needed to enhance awareness of post-treatment dysfunction to guide shared decision making with patients and inform novel post-surgical rehabilitation interventions for breast cancer survivors.