Shoulder Range of Motion Decline After Breast Cancer Surgery

SHOULDER joint range of motion fell markedly 1 month after breast cancer surgery in Japan despite routine inpatient rehabilitation. Shoulder Joint Range of Motion Limits Common at 1 Month Early reductions in shoulder joint range of motion can meaningfully affect recovery after breast cancer surgery, limiting activities such as dressing, grooming, reaching, and overhead movement. In a retrospective cohort study from Japan, investigators evaluated factors linked to passive shoulder flexion and abduction restriction 1 month after surgery in patients undergoing inpatient rehabilitation. Using an electronic medical database at a university hospital, the study identified patients who completed inpatient rehabilitation following breast cancer surgery between May 2014 and April 2020. Extracted variables included age, affected side, body mass index, number and level of axillary lymph nodes removed, type of mastectomy, chemotherapy, radiation therapy, postoperative drain duration, and length of hospital stay. Passive shoulder flexion and abduction range of motion were assessed before surgery and again at 1 month postoperatively. Multivariable logistic regression was used to examine factors associated with shoulder joint range of motion limitation at that timepoint. Among 258 included patients, 210 (81.4%) had a shoulder joint range of motion limitation 1 month after surgery. On average, shoulder flexion and abduction decreased by 31.3° and 35.9°, respectively, indicating substantial early restriction even in the context of inpatient rehabilitation. Which Factors Predicted Shoulder Joint Range of Motion Limitation? Three variables were significantly associated with shoulder joint range of motion limitation after surgery: older age, greater number of nodes removed, and total mastectomy. These factors may help clinicians anticipate which patients are more likely to experience clinically meaningful restriction during the first postoperative month. Clinical Implications for Rehabilitation Planning For U.S. teams supporting postoperative breast cancer care, these findings offer practical prognostic context for counseling and care planning. Patients who are older or undergo total mastectomy and more extensive nodal removal may benefit from closer follow-up, earlier goal-setting, and individualized rehabilitation pacing to support functional recovery and independence. Reference: Koyama S et al. Factors affecting shoulder joint range of motion after breast cancer surgery: a retrospective cohort study in Japan. Support Care Cancer. 2026;34(2):97. doi: 10.1007/s00520-025-10260-y.