From the Guidelines
There is no direct evidence that a mastectomy makes people more susceptible to bursitis. Mastectomy, which is the surgical removal of breast tissue, primarily affects the chest area and does not directly impact the joint structures where bursitis typically occurs. Bursitis is inflammation of the bursae, small fluid-filled sacs that cushion joints, tendons, and muscles. While some mastectomy patients may experience shoulder stiffness or limited range of motion following surgery, particularly if lymph nodes were removed, these issues are distinct from bursitis, as noted in the american cancer society/american society of clinical oncology breast cancer survivorship care guideline 1.
Some key points to consider include:
- Post-mastectomy patients may report difficulties with the ipsilateral upper extremity after surgery, including decreased range of motion, rotator cuff injury, adhesive capsulitis, and axillary web syndrome 1.
- These abnormalities can lead to a decreased ability to perform activities of daily living and can impact employment, but they are not directly related to bursitis.
- Systemic therapies for breast cancer have been associated with the development of musculoskeletal symptoms, including arthralgias and myalgias, but again, these are not directly related to bursitis 1.
- Post-mastectomy physical therapy often focuses on maintaining shoulder mobility and strength, which may actually help prevent shoulder problems, including bursitis.
- If you've had a mastectomy and are experiencing joint pain, it's essential to consult with your healthcare provider, as the symptoms may be related to other factors, such as medication side effects, post-surgical complications, or unrelated musculoskeletal conditions, rather than being a direct consequence of the mastectomy itself.
From the Research
Mastectomy and Bursitis
- A mastectomy may increase the risk of developing bursitis, as suggested by a study published in the Annals of Surgical Oncology 2, which found that 27.2% of patients with shoulder bursitis had a history of previous mastectomy.
- Another study published in Supportive Care in Cancer 3 found that mastectomy was a significant risk factor for adhesive capsulitis of the shoulder, which can be related to bursitis.
- However, it is essential to note that bursitis is not exclusively caused by mastectomy, and other factors such as radiation therapy, muscle spasms, and neuropathy can also contribute to its development 4.
- A study published in the American Journal of Clinical Oncology 5 found that mastectomy increased the risk of arm edema, limited shoulder motion, and shoulder pain, which can be related to bursitis.
Risk Factors and Complications
- Age, particularly between 50-59 years, is also a significant risk factor for adhesive capsulitis and potentially bursitis 3.
- Breast reconstruction after mastectomy may further increase the risk of adhesive capsulitis and bursitis 3.
- Post-mastectomy pain syndrome, which can include bursitis, affects 25-60% of people after breast surgery 4.
- Interventional pain management options, such as botulinum toxin injections and nerve blocks, can be used to treat post-mastectomy pain syndrome, including bursitis 4.