NCT06012786

Brief Summary

The goal of this observational study is to determine the relationship between Lymphedema and Myofascial Pain Syndrome in Breast Cancer Patients. The main questions it aims to answer:

  • Is there a relationship between the stage of lymphedema and the frequency of accompanying myofascial pain syndrome in the breast cancer patients?
  • Does the existence of lymphedema in breast cancer patients affect the distribution and the pain threshold values of trigger points seen in Myofascial Pain Syndrome?
  • What is the impact of Myofascial pain syndrome seen in breast cancer associted lymhedema patients on upper extremity function and quality of life?

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
110

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Aug 2023

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 22, 2023

Completed
3 days until next milestone

First Posted

Study publicly available on registry

August 25, 2023

Completed
5 days until next milestone

Study Start

First participant enrolled

August 30, 2023

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 30, 2024

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 20, 2025

Completed
Last Updated

September 12, 2025

Status Verified

September 1, 2025

Enrollment Period

1 year

First QC Date

August 22, 2023

Last Update Submit

September 5, 2025

Conditions

Keywords

breast cancermyofascial pain syndromelymphedema

Outcome Measures

Primary Outcomes (2)

  • The Evaluation of Trigger Points

    Trigger points in trapezius, infraspinatus, latissimus dorsi, pectoralis major, serratus anterior muscles will be detected bilaterally by physical examination. Algometer (Wagner Force Dial FDK 20) will be used for pain pressure threshold measurement of detected trigger points. Then, the distribution of the trigger points, their frequency and threshold values according to the algometer will be compared between the individual affected-insured extremities and between the groups.

    3 days

  • Clinical Diagnostic Criteria of Myofascial Pain Syndrome

    Major criteria: 1. The patient's complaint of regional pain 2. Referred pain and sensory change in the specific area of the muscle by palpation of the trigger point 3. Presence of palpable taut band 4. Presence of palpable and tender points along the length of the taut band 5. Restriction of ROM in the area of the affected muscle Minor criteria: 1. Pain/sensory change with pressure palpation of the trigger point 2. Local twitch response with palpation/injection of the trigger point in the taut band 3. Reduction of pain by inactivation (injection or stretching of the muscle) of the trigger point 5 major and at least 1 minor criteria are required for clinical diagnosis

    3 days

Secondary Outcomes (5)

  • Hand Grip Test

    3 days

  • Range of motion of shoulder joint

    3 days

  • VAS

    3 days

  • Quick-DASH (The Disabilities of the Arm, Shoulder and Hand)

    3 days

  • LYMQOL-arm (Lymphedema Quality of Life -arm)

    3 days

Study Arms (2)

Group 1 (Patients with Stage 0 lymphedema)

It is known that pathophysiological changes develop even if there is no visible lymphedema in patients undergoing surgery and/or radiotherapy for breast cancer. There is a lifetime risk of developing lymphedema, so these patients are considered as Stage 0 (latent). The patients with less than 3 cm difference between the circumference measurements of upper extremities will be included in the 1st group.( Stage 0) (n=55)

Diagnostic Test: Diagnostic Criteria of Myofascial Pain SyndromeDiagnostic Test: The Physical Examination of Trigger Points and Pain-Pressure Threshold Measurement With an AlgometerDiagnostic Test: Hand Grip TestDiagnostic Test: VASDiagnostic Test: Quick DASHDiagnostic Test: Lymqol-ArmDiagnostic Test: Range of Motion of Shoulde Joint

Group 2 (Patients with Stage 1,2 or 3 lymphedema)

Patients who have more than 3 cm difference between the circumference measurements of upper extremities and those with Stage 1,2 or 3 lymphedema will be included in the second group (n=55)

Diagnostic Test: Diagnostic Criteria of Myofascial Pain SyndromeDiagnostic Test: The Physical Examination of Trigger Points and Pain-Pressure Threshold Measurement With an AlgometerDiagnostic Test: Hand Grip TestDiagnostic Test: VASDiagnostic Test: Quick DASHDiagnostic Test: Lymqol-ArmDiagnostic Test: Range of Motion of Shoulde Joint

Interventions

Major criteria: 1. The patient's complaint of regional pain 2. Referred pain and sensory change in the specific area of the muscle by palpation of the trigger point 3. Presence of palpable taut band 4. Presence of palpable and tender points along the length of the taut band 5. Restriction of ROM in the area of the affected muscle Minor criteria: 1. Pain/sensory change with pressure palpation of the trigger point 2. Local twitch response with palpation/injection of the trigger point in the taut band 3. Reduction of pain by inactivation (injection or stretching of the muscle) of the trigger point 5 major and at least 1 minor criteria are required for clinical diagnosis

Group 1 (Patients with Stage 0 lymphedema)Group 2 (Patients with Stage 1,2 or 3 lymphedema)

Trigger points in trapezius, infraspinatus, latissimus dorsi, pectoralis major, serratus anterior muscles will be detected bilaterally by physical examination. Algometer (Wagner Force Dial FDK 20) will be used for pain pressure threshold measurement of detected trigger points. Then, the distribution of the trigger points, their frequency and threshold values according to the algometer will be compared between the individual affected-insured extremities and between the groups.

Group 1 (Patients with Stage 0 lymphedema)Group 2 (Patients with Stage 1,2 or 3 lymphedema)
Hand Grip TestDIAGNOSTIC_TEST

The purpose of this test is to test the maximum isometric contraction strength of the hand and forearm muscles. A hand grip dynamometer (Jamar) will be used for the test. While the patient is sitting in the chair, the elbows will be close to the body and at 90 degree flexion, the wrist will be in a neutral position. The patient will be asked to grasp the dynamometer and squeeze it as hard as she can, and the average of 3 measurements made with an interval of 5 minutes. The test will be repeated for both upper extremities separately.

Group 1 (Patients with Stage 0 lymphedema)Group 2 (Patients with Stage 1,2 or 3 lymphedema)
VASDIAGNOSTIC_TEST

Shoulder pain, feeling of tension and heaviness on the affected arm will be evaluated separately by numerical scale.

Group 1 (Patients with Stage 0 lymphedema)Group 2 (Patients with Stage 1,2 or 3 lymphedema)
Quick DASHDIAGNOSTIC_TEST

The quick DASH questionnaire which has proven reliable and valid in breast cancer and lymphedema patients in Turkish population, will be used to evaluate the quality of life related to upper extremity function.

Group 1 (Patients with Stage 0 lymphedema)Group 2 (Patients with Stage 1,2 or 3 lymphedema)
Lymqol-ArmDIAGNOSTIC_TEST

Lymphedema Quality of Life Scale-Arm Turkish form will be used. The lymphedema-specific quality of life scale was developed specifically for the upper extremity and its reliability and validity were proven in Turkish population.

Group 1 (Patients with Stage 0 lymphedema)Group 2 (Patients with Stage 1,2 or 3 lymphedema)

Goniometric measurements will be made for both upper extremities, and the average of 3 consecutive measurements will be taken.

Group 1 (Patients with Stage 0 lymphedema)Group 2 (Patients with Stage 1,2 or 3 lymphedema)

Eligibility Criteria

Age18 Years - 75 Years
Sexfemale(Gender-based eligibility)
Gender Eligibility DetailsFemale Breast Cancer Patients
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Breast Cancer patients aged between 18-75 years old, who had undergone the treatments as mastectomy, breast conserving surgery, lymph node dissection, sentinele lymph node biopsy or radiotherapy visiting our oncological rehabilitation outpatient clinic between August 2023 and May 2024.

You may qualify if:

  • Breast cancer patients aged between 18-75 who had undergone the treatments as mastectomy, breast conserving surgery, lymph node dissection, sentinele lymph node biopsy or radiotherapy providing a written consent to participate in the study

You may not qualify if:

  • Patients who do not agree to participate the study
  • Patients who had signs of active infection as lymphangitis, cellulitis, fungus
  • Bilateral breast cancer patients
  • Uncontrolled Psychiatric illness

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Sultan 2. Abdulhamid Han Training and Research Hospital

Istanbul, Kadıköy, 34668, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Myofascial Pain SyndromesBreast NeoplasmsLymphedemaPain

Condition Hierarchy (Ancestors)

Muscular DiseasesMusculoskeletal DiseasesNeoplasms by SiteNeoplasmsBreast DiseasesSkin DiseasesSkin and Connective Tissue DiseasesLymphatic DiseasesHemic and Lymphatic DiseasesNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Yeliz Bahar Özdemir

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE ONLY
Time Perspective
CROSS SECTIONAL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 22, 2023

First Posted

August 25, 2023

Study Start

August 30, 2023

Primary Completion

August 30, 2024

Study Completion

February 20, 2025

Last Updated

September 12, 2025

Record last verified: 2025-09

Locations