Journal CME, January 2024: Brachial plexopathy after breast cancer: A persistent late effect of radiotherapy-Journal CME, January 2024: Brachial plexopathy after breast cancer: A persistent late effect of radiotherapy

Journal CME, January 2024: Brachial plexopathy after breast cancer: A persistent late effect of radiotherapy

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Brachial plexopathy is a late effect of radiotherapy that can occur in breast cancer survivors. It is a chronic and irreversible nerve injury that is often not associated with cancer treatments received years prior. Symptoms of brachial plexopathy include paresthesia, hypoesthesia, dysesthesia, weakness in the hand, and muscle fasciculations. These symptoms progress from distal to proximal up through the shoulder. Brachial plexopathy is typically seen when axillary and/or supraclavicular lymph nodes, as well as the breast/chest wall, have been irradiated. It is often misdiagnosed or missed due to its rarity and the lack of awareness among healthcare providers. Physiatrists and rehabilitation professionals need to be aware of this condition to provide proper diagnoses and rehabilitation therapies. Professional oncology organizations should also include brachial plexopathy in their long-term, survivorship guidelines for breast cancer. Researchers studying the late effects of radiotherapy should extend their follow-up periods to accurately assess the incidence of brachial plexopathy today. It is important for primary care providers, oncologists, and rehabilitation professionals to be aware of the existence of brachial plexopathy and refer patients for appropriate testing and management. Long-term cancer survivors may experience these iatrogenic outcomes, and rehabilitative care should be provided to improve their quality of life.

Keywords

brachial plexopathy

late effect

radiotherapy

breast cancer survivors

nerve injury

paresthesia

hypoesthesia

dysesthesia

muscle weakness

rehabilitation therapies