Assessment of Shoulder Dysfunction in Patients After Axillary Dissection: A Prospective Observational Study Using Needle Electromyography

Axillary lymph node dissection (ALND) is routinely performed for nodal staging and disease control in breast cancer and selected skin and soft tissue malignancies. Despite its oncological benefits, ALND contributes to postoperative complications such as lymphedema, pain, and particularly shoulder dysfunction due to potential injury to the medial/lateral pectoral, long thoracic, and thoracodorsal nerves. These complications can impair range of motion (ROM), cause pain, and reduce quality of life. While studies have reported shoulder dysfunction post-ALND, few have employed objective tools like electromyography (EMG) to quantify nerve damage. This study uses needle EMG and clinical parameters to assess the functional impact of ALND on shoulder mechanics.