Dextrose injections to loosen chest wall and armpit tightness after breast cancer

Effectiveness of Ultrasound-Guided Dextrose Prolotherapy for Persistent Chest Wall and Axillary Symptoms in Breast Cancer Survivors: A Prospective Case Series.

This will try ultrasound-guided dextrose injections to relieve persistent chest wall and armpit tightness and improve arm function in women who had breast cancer and did not improve with physical therapy.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 15 (estimated)
• Ages: 18 Years and up
• Sex: Female
• Sponsor: Taichung Veterans General Hospital (Academic / other)
• Locations: 1 site (Taichung, Taiwan)
• Trial ID: NCT07378319 on ClinicalTrials.gov

What this trial studies

This prospective case series uses ultrasound-guided 5% dextrose hydrodissection to separate adhered fascial planes in the ipsilateral chest wall and axilla of female breast cancer survivors. Participants undergo a baseline physical and ultrasound exam and then receive three targeted injection sessions at four-week intervals. Primary outcomes include upper-extremity function measured by QuickDASH, with secondary outcomes of pain intensity (NRS), active shoulder range of motion, and pectoralis minor muscle length. Safety, feasibility, and preliminary clinical effects will be recorded.

Who should consider this trial

Good fit: Female breast cancer survivors aged 18 or older with at least 3 months of ipsilateral chest wall or axillary pain/tightness, significant baseline symptoms (QuickDASH ≥25 or NRS ≥5), and inadequate improvement after 12 weeks of standard physical therapy are ideal candidates.

Not a fit: Patients with local cancer recurrence, metastatic disease, active lymphedema requiring ongoing decongestive therapy, or those who have not completed adequate physical therapy are unlikely to receive benefit from this intervention.

Why it matters

Potential benefit: If successful, the procedure could reduce pain and improve shoulder and arm function by mechanically releasing scarred soft tissues and promoting local tissue remodeling.

How similar studies have performed: Dextrose prolotherapy and hydrodissection have shown promise in small case series for musculoskeletal adhesions, but high-quality trials specifically for post-breast cancer chest wall tightness are limited.

Eligibility criteria

Inclusion Criteria:

* History of breast cancer surgery (mastectomy or breast-conserving surgery), with or without axillary lymph node dissection
* Persistent ipsilateral chest wall and/or axillary pain, tightness, or movement restriction lasting ≥ 3 months after surgery;
* Clinically significant baseline symptom severity, defined as Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire ≥ 25 and/or pain intensity ≥ 5/10 on the Numeric Rating Scale (NRS);
* Completion of 12 weeks of standard physical therapy with no significant improvement, defined as a change in QuickDASH score from baseline to completion of therapy below the minimal clinically important difference (MCID; \<15 points ) and/or pain improvement \< 2 points on the NRS .
* Age ≥ 18 years;
* Ability to provide written informed consent.

Exclusion Criteria:

* Evidence of local cancer recurrence or metastatic disease;
* Active lymphedema requiring ongoing decongestive therapy at the time of enrollment;
* Shoulder pathology, including intra-articular or peri-articular conditions (e.g., adhesive capsulitis with marked capsular restriction, or acute rotator cuff tear,) judged by clinical assessment to be the dominant cause of symptoms.
* Active infection, skin lesion, or unhealed surgical wound at the intended injection site;
* Known bleeding disorders or anticoagulant use contraindicating injection;
* Known allergy to dextrose or any components of the injection protocol;
* Pregnancy or other medical conditions precluding participation.

Where this trial is running

Taichung, Taiwan

• Taichung Veterans Genetal Hospital — Taichung, Taiwan, Taiwan (Recruiting)

Study contacts

• Principal investigator: Yuchun Lee, M.D. — Taichung Veterans General Hospital
• Study coordinator: Yuchun Lee, M.D.

Conditions Breast Cancer Females; breast cancer; dextrose injection