{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:31:48Z","timestamp":1786426308919,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100008259","name":"Fru Astrid Thaysens Legat for L\u00e6gevidenskabelig Grundforskning","doi-asserted-by":"publisher","award":["ATL 19\/03"],"award-info":[{"award-number":["ATL 19\/03"]}],"id":[{"id":"10.13039\/501100008259","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer survival has improved substantially, yet many women continue to experience late effects that may require physiotherapy. Shoulder impairment, lymphedema, and fatigue are among the most common physiotherapy\u2010relevant late effects following primary breast cancer treatment. Understanding how guideline treatments for breast cancer influence these impairments is essential for the early identification of high\u2010risk patients and the development of targeted rehabilitation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the association between Danish guideline treatments for breast cancer and the risk of three physiotherapy\u2010relevant self\u2010reported late effect dimensions 3\u20137\u00a0years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>National cohort study of 5729 women who underwent surgical treatment for primary breast cancer between 2015 and 2019. Participants completed a questionnaire 3\u20137\u00a0years postoperatively addressing shoulder impairment, lymphedema, and fatigue. Treatment codes were extracted from the Danish National Patient Registry and categorized according to Danish guideline regimens for surgery and radiotherapy. Logistic regression analyses, adjusted for relevant confounders, were performed to estimate associations, and absolute risks were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with breast\u2010conserving surgery (BCS) and sentinel lymph node biopsy (SLNB) with radiotherapy, treatment combinations involving mastectomy or axillary lymph node dissection (ALND) with radiotherapy were associated with approximately threefold higher odds of self\u2010reported late effects. The highest risk was observed after mastectomy and SLNB with radiotherapy (OR\n                      <jats:sub>adj<\/jats:sub>\n                      3.10, 95% CI 2.48\u20133.88), followed by mastectomy with ALND and radiotherapy (OR\n                      <jats:sub>adj<\/jats:sub>\n                      2.90, 95% CI 2.02\u20134.15) and BCS with ALND and radiotherapy (OR\n                      <jats:sub>adj<\/jats:sub>\n                      2.76, 95% CI 2.25\u20133.39). Shoulder impairment was consistently the most frequent self\u2010reported late effect across all treatment types.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Guideline treatments involving mastectomy, and\/or ALND in combination with radiotherapy substantially increased the risk of self\u2010reported late effects, particularly shoulder impairment. These findings highlight the need for early targeted physiotherapy interventions and improved detection strategies to mitigate late effects in breast cancer survivors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70314","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:21:50Z","timestamp":1786425710000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Danish Guideline Treatments for Breast Cancer and Physiotherapy\u2010Relevant Late Effects: A Nationwide Cohort Study"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3088-1833","authenticated-orcid":false,"given":"Kim Mich\u00e9le","family":"Feder","sequence":"first","affiliation":[{"name":"Department of Physiotherapy Lillebaelt Hospital\u2014Vejle University Hospital of Southern Denmark  Vejle Denmark"},{"name":"Department of Regional Health Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9727-6649","authenticated-orcid":false,"given":"Lonny","family":"Stokholm","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4571-7852","authenticated-orcid":false,"given":"Hans Bjarke","family":"Rahr","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research University of Southern Denmark  Odense Denmark"},{"name":"Department of Surgery Lillebaelt Hospital\u2014Vejle, University Hospital of Southern Denmark  Vejle 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