Measurement of objective shoulder function following breast cancer surgery: a scoping review

Background: Shoulder dysfunction is frequently experienced by survivors of breast cancer following surgery, and it is associated with both reduced ability to perform daily living tasks and decreased overall quality of life. Shoulder function is often measured with self-reported questionnaires. It is not known to what extent shoulder function has been objectively measured in order to accurately assess return-to-work related outcomes. Objectives: This review aimed to determine what is known about objectively evaluated shoulder function following breast cancer. Methods: A comprehensive search of several databases was performed to identify all relevant research. All identified studies were screened and those including the objective measurement of shoulder function of survivors of breast cancer post-surgery were included. Data were extracted by two reviewers and results were consolidated and presented. Results: The majority (71%, n = 175) of studies measured range of motion to assess function of the shoulder in survivors of breast cancer. Range of motion was usually with goniometers (57%, n = 141). Strength was the second most common functional outcome reported. The use of functional work tasks or activities of daily living to assess shoulder ability or capacity was limited to less than 5% (n = 7) of studies. Most studies used baseline measures to assess outcomes (61%, n = 150), while 29% (n = 72) explicitly used the contralateral arm to evaluate dysfunction. Conclusion: Range of motion and shoulder strength are frequently measured in survivors of breast cancer. Future investigations should focus on functional movements and outcomes to assess shoulder function, especially for the return-to-work considerations.