Prevalence and Risk Factors of Adhesive Capsulitis in Asian Breast Cancer Patients Undergoing an Outpatient Community Cancer Rehabilitation Program

Arch Phys Med Rehabil. 2021 May;102(5):843-848. doi: 10.1016/j.apmr.2020.10.105. Epub 2020 Oct 24.


Objectives: To investigate the prevalence and risk factors for adhesive capsulitis in postoperative breast cancer patients up to 5 years after surgery who were attending an outpatient community cancer rehabilitation program, and to determine whether any significant relationship exists between arm lymphedema and adhesive capsulitis.

Design: Cross-sectional observational study.

Setting: National cancer rehabilitation center.

Participants: Asian women (N=135) who underwent breast surgery and were referred for an outpatient community cancer rehabilitation program.

Interventions: Not applicable.

Main outcome measures: Presence of adhesive capsulitis, lymphedema.

Results: The prevalence of adhesive capsulitis and lymphedema in this population was 22.2% and 33.3%, respectively. A history of mastectomy (odds ratio [OR], 3.93; 95% confidence interval [CI], 1.23-12.63; P=.021), mastectomy with reconstruction (OR, 2.72; 95% CI, 1.27-30.54; P=.024), and lymphedema (OR, 7.92; 95% CI, 2.73-22.95; P<.001) were found to be significantly associated with adhesive capsulitis on multivariate analysis.

Conclusions: Adhesive capsulitis and lymphedema are common in breast cancer survivors. The design of cancer rehabilitation programs for breast cancer survivors should include surveillance and management of adhesive capsulitis, especially in the presence of lymphedema.

Keywords: Breast neoplasms; Community health services; Lymphedema; Rehabilitation; Survivorship.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Asia / epidemiology
  • Breast Neoplasms / surgery*
  • Bursitis / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lymphedema / epidemiology*
  • Mastectomy*
  • Middle Aged
  • Outpatients
  • Postoperative Complications / epidemiology
  • Prevalence
  • Risk Factors