# Association between preoperative grip strength and postoperative upper extremity impairments in patients with breast cancer: a retrospective cohort study

## TL;DR

This study found that lower preoperative grip strength is linked to worse upper limb function after breast cancer surgery, suggesting prehabilitation could help.

## Contribution

The study identifies preoperative grip strength as a novel modifiable risk factor for postoperative upper extremity impairments in breast cancer patients.

## Key findings

- Lower preoperative grip strength was significantly associated with higher postoperative DASH scores.
- Adjusting for confounding factors confirmed the relationship between grip strength and upper extremity impairments.
- Prehabilitation to improve muscle strength before surgery may reduce postoperative complications.

## Abstract

Upper extremity impairments in patients with breast cancer persist after curative surgery. Although postoperative factors associated with upper extremity impairments have been reported, modifiable factors affecting these impairments preoperatively remain unclear. This study aimed to investigate the relationship between preoperative grip strength and postoperative upper extremity impairments in patients with breast cancer.

This retrospective cohort study included patients (age ≥ 18 years) with breast cancer who underwent mastectomy. Maximum grip strength was measured on the day before surgery. Upper extremity impairments were assessed 4–16 months after surgery using the Disabilities of the Arm, Shoulder and Hand (DASH) scale. Multiple linear regression analysis was used to evaluate the association between preoperative grip strength and postoperative upper extremity impairments.

In total, 72 patients were included in the analysis. Multiple linear regression analysis showed that preoperative grip strength was significantly associated with the postoperative DASH score after adjusting for confounding factors (β = − 1.27, 95% confidence interval − 2.08 to − 0.48, p = 0.002).

This study showed that low preoperative grip strength is a risk factor for postoperative upper extremity impairments in patients with breast cancer. Providing prehabilitation to maintain and improve muscle strength immediately after diagnosis is important. Moreover, an individualized follow-up protocol according to preoperative screenings to prevent postoperative upper extremity impairments is necessary.

The online version contains supplementary material available at 10.1007/s12282-025-01699-2.