Upper Arm Disability After Axillary Surgery for Early Breast Cancer Using the Dash© Assessment

Karen Mbaabu1, Ronald Wasike2, Robinson Karuga3

  1. Department of Surgery, The Mater Hospital, Nairobi

  2. Department of Surgery, The Aga Khan University Hospital, Nairobi

  3. Synergy Research Consultants, Nairobi

Correspondence to: Dr. Mbaabu Karen, The Mater Hospital, Nairobi; email: karenmbaabu@gmail.com


Background: Treatment of early breast cancer includes surgical removal of the tumor and evaluation of axillary lymph nodes. Axillary lymph node surgery is associated with upper arm morbidity. The impact of this upper arm limitation has a direct effect on the patient’s quality of life. Objectives: To quantify the symptoms of upper extremity disability and identify correlations between severity of symptoms and type of axillary surgery. Methods: An observational study was performed on 2 groups of patients who had undergone surgery for breast cancer. A retrospective group, which comprised patients who had undergone axillary surgery 2 years prior to the study, and a prospective group of patients who had undergone axillary surgery 6 weeks from study commencement. Data was collected using the DASH® questionnaire and analyzed using SPSS v13®. Results: All 102 participants reported upper extremity symptoms. The mean DASH score for all participants was 51.7. Participants in the retrospective arm had a higher DASH score of 53; those in the prospective arm had a score of 47.3. There was no correlation between severity of symptoms and type of axillary surgery performed. Conclusion: There is a need to implement targeted rehabilitation services after the primary surgery.


Key words: Early breast cancer, Axillary dissection, DASH score, Upper arm disability

Ann Afr Surg. 2019; 17(1):*** DOI:http://dx.doi.org/10.4314/aas.v***.*

Conflicts of Interest: None

Funding: None

© 2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.


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