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Outcomes after carpal tunnel release in breast cancer patients: a case-control study
Isaac Mordukhovich; Christina Lee, MD; Samantha Maasarani, MD; Mazen Al-Malak, MD; Ying Ku, DO; Jacob Lammers, DO; Bahar Bassiri Gharb, MD PhD; Antonio Rampazzo MD, PhD
Case Western Reserve University School of Medicine
2025-01-16
Presenter: Isaac Mordukhovich
Affidavit:
certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Bahar Bassiri Gharb, MD PhD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Objective: This study is an evaluation of carpal tunnel release (CTR) treatment and outcomes in patients with breast cancer diagnoses.
Methods: A retrospective case-control chart review study was performed in the Cleveland Clinic's Electronic Medical Record. Study inclusion criteria: female patients over 18 years old with histories of CTR and carpal tunnel syndrome (CTS) diagnosis. The case group also required prior treatment of breast cancer not arising from metastasis. Chi-square, Welch's, and Fisher's tests were used as appropriate with Bonferroni corrections.
Results: Ninety-eight patients were included in the case (BRCA) group and 200 patients were included in the control. Despite efforts to match patients, mean ages differed between the groups (63.1±11.9 vs. 51.1±12.8 years; p<0.01). The control group was more likely to have chronic kidney disease than the BRCA group (p<0.01), although other CTS-predisposing comorbidities had equal occurrence between groups. BRCA subjects received breast-conserving (67.0%), simple mastectomy (21.6%), modified radical mastectomy (7.2%), or other non-radical mastectomy (4.1%) surgeries. Upon CTS diagnosis, the BRCA group's conservative treatments were shorter (p<0.01) than the control group's and less likely to include orthosis or steroid injections (p<0.0125) without any difference in subjective improvement (p=0.725). Following CTR, both groups' DASH scores improvements were clinically significant (ΔDASHBRCA=40.01±19.29, ΔDASHcontrol=24.14±23.98 > 10). The BRCA group's relative DASH (p=0.034), BCTQ-F (p<0.01), and BCTQ-S (p<0.01) improvements were greater than the control's.
Conclusion: Breast cancer patients had greater reductions in CTS severity following CTR and similar responses to conservative therapy compared to other patients despite abbreviated conservative treatment durations.
