Prevalence and Clinical Pattern of Radiation-Induced Cervicothoracic Musculoskeletal and Neurological Disorders in Breast Cancer Survivors: A Prospective Observational Study

Introduction: This prospective observational study investigates the prevalence and clinical patterns of radiation-induced cervicothoracic musculoskeletal and neurological disorders in breast cancer survivors. By systematically tracking these long-term morbidities following radiotherapy, the study aims to provide critical evidence to optimize screening protocols, improve supportive care pathways, and enhance the overall quality of life for this vulnerable patient population. Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital in Tabriz, Iran, and enrolled 175 breast cancer survivors through convenience sampling. The sample size was estimated using Cochran’s formula for prevalence studies. Trained clinicians collected demographic, cancer-treatment, and radiotherapy data and assessed cervicothoracic musculoskeletal symptoms, neurological complaints, and relevant examination findings using a standardized protocol. Results: Cervicothoracic musculoskeletal and neurological impairments were highly prevalent, predominantly manifesting as ipsilateral myofascial pain (50.3% [42.9-57.7]) and neuropathic pain (27.4% [21.1-34.6]). Multivariable analysis identified supraclavicular nodal irradiation (aOR=2.18 [1.21-3.92], P=0.009), axillary dissection (aOR=1.74 [1.02-3.01], P=0.042), and >12 months post-radiotherapy interval (aOR=1.81 [1.01-3.25], P=0.047) as independent risk factors (P<0.05). Conclusion: Cervicothoracic musculoskeletal and neurological complications frequently afflict breast cancer survivors, showing strong independent associations with supraclavicular radiotherapy and axillary surgery. These findings underscore the imperative for targeted prospective screening and early rehabilitative interventions tailored to high-risk locoregional treatment profiles.