The effect of physiotherapy in patients with modified radical mastectomy (original) (raw)
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The Efficacy of Physiotherapy Recovery After a Modified Radical Mastectomy
Journal of Medical pharmaceutical and allied sciences, 2021
Breast cancer is the most common disease in females and the major cause of mortality and morbidity. In reality, 1.67 million new cases of breast cancer are diagnosed around the world, with 458,000 deaths per year. Approximately 89 percent of breast cancer survivors live for a minimum of five years after treatment, but adverse effects can last for months or years after surgery. The most common side effects of the upper limb are pain and joint dysfunction, which is described as having a prevalence range of 12 percent to 51 percent for pain and 1.5 percent to 50 percent for joint dysfunction.(1) The mainstay in primary breast cancer care is surgery.(2) To assess the impact of an early recovery program on shoulder mobility, functional ability, postoperative complications such as seroma, hematoma, and wound infection in patients who had undergone a modified radical mastectomy (MRM)and to assess the impact of variables in clinical practice (e.g., age, education, BMI, previous shoulder pro...
Physiotherapeutic performance in mastectomy after breast cancer: a literature review
Journal of Cancer Prevention & Current Research, 2021
Cancer is characterized by disorganized and chaotic cell growth that results from genetic changes inherited or acquired by the action of certain environmental, chemical, radioactive, viral and hormonal agents named carcinogens, which thereby initiate the process of tumorigenesis. 1 Breast cancer is the second most common form of cancer in the world and the leading cause of death by cancer among females. It mainly affects women aged between 40 and 60 years. 1,2 The main risk factors are genetics and external, such as environment, living habits, eating habits, age, menarche, exposure to estrogen, radiation, obesity, sedentarism and environmental toxins. 1,2 According to the World Health Organization (WHO), about 40% of deaths could be prevented by eliminating or minimizing exposure to carcinogens. Primary prevention consists in promoting health and avoiding external risk factors. Secondary prevention involves actions aimed at early diagnosis of the disease. The main objectives of treatments are to cure, prolong survival and improve the quality of life (QoL) of patients. 1 Primary treatment for breast neoplasm is a surgical intervention called mastectomy, whose goal is tumor removal. The most commonly used surgical procedure is modified radical mastectomy, in which the entire breast is removed, along with axillary lymph nodes. 1,3,4 After mastectomy, women face a psychological trauma. These feelings lead them to explore the possibilities of breast reconstruction, in order to reconstitute their body image, with improvements to QoL and well-being, so it should be considered as an integral part of breast cancer treatment. 5 Treatment-associated morbidities include paresthesia of the axillary region and the lateral wall of the thorax, pain, enlargement of upper limb, reduction of shoulder's range of motion, limitation of daily living activities (DLAs), and interference in QoL. 6 Patients undergoing physical therapy have their recovery time reduced and return more quickly to their daily, occupational and sports activities, as well as can reacquire movement amplitude, strength, good posture, coordination, self-esteem and, mainly, minimize possible postoperative complications and increase their QoL. 3 In the preoperative phase, the work of musculature maintenance is important, besides a previous evaluation of the patient's overall conditions. The post-surgical treatment aims at a significant improvement in skin texture, absence of fibrotic nodulation, reduction of edema, pain relief, minimization of possible tissue adhesions, rapid recovery of areas with hypoesthesia, that is, less of complications and acceleration of patient's return to daily activities. 7,8 The main physical therapy resources used to achieve that, are: manual lymphatic drainage, ultrasound, cryotherapy, laser therapy, electrotherapy, active exercises and complex decongestive therapy (CDT), which is fundamental to the recovery process. 7 Because of the high incidence of breast cancer, and the search for a treatment that ranges from tumor removal surgery to breast reconstruction
Impact of Physical Therapy in Patients Undergoing Modified Radical Mastectomy: A Case Report
Journal of Pharmaceutical Research International, 2021
Introduction: Breast Cancer is responsible for 2.09 million cases and 6,27,000 deaths worldwide, as per WHO. In India, women have one of the most common cancer, accounting for 14 per cent of all women's cancers. Numerous risk factors are present, such as ethnicity, aging, hormones, family medical history, genetic abnormalities, and unhygienic lifestyles. Side effects of cancer treatment may be alleviated by exercise interventions. Physical- therapy has been shown to be effective in post-operative situations. It improves the functioning of the patient and the quality of life. Presenting Symptoms and Diagnosis: Main symptoms from the patient were pain in the upper extremity, lack of control, power and range of motion. The main clinical results in this case have been a severe decrease in the range of shoulder joint motion. Reduced strength in the upper extremity muscles and swelling (lymphoedema) in the upper extremity. Diagnosis of the case was Infiltrative Ductal Carcinoma th...
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.3\_March2022/IJHSR-Abstract.018.html, 2022
Early breast cancer treatment can cause shoulder dysfunction, which is a well-known and prevalent adverse effect (1). In individuals treated surgically for breast cancer, physiotherapy was found to enhance shoulder function considerably (1). Breast cancer is the most common type of cancer in women and the leading cause of death and morbidity (2). Every year, 1.67 million new instances of breast cancer are identified worldwide, with 458,000 fatalities (2). Although 89 percent of breast cancer survivors live for at least five years after treatment, side symptoms can continue for months or even years(2). The most common upper-limb side effects are pain and joint dysfunction, with prevalence rates ranging from 12% to 51% for pain and 1.5 percent to 50% for joint dysfunction. Surgery is the most common treatment for primary breast cancer. Shoulder exercises are commonly advised to reduce mobility and strength loss as well as prevent lymphedema. Several clinical services have been developed to help with shoulder range of motion rehabilitation and secondary lymphedema prevention(3). The goal of this study was to see how additional postoperative physiotherapy affected shoulder function after the initial postoperative healing period, especially when given for a longer period. Patients who have had a mastectomy are always at risk of getting shoulder pain and adhesive capsulitis, and they must take precautions (3).
Physical and Psychological Complications of Mastectomy: The Role of Physioterapy
2020
Breast cancer affects a large number of women worldwide. Surgical management has evolved towards mastectomies and breast-conserving surgeries. The complications following a mastectomy can be physical and/or psychological. The physical complications include pain, scarring, lymphedema, limitation in range of motion at the shoulder, muscle weakness, change in body posture, etc. Some of the psychological complications are negative boy image, anxiety, depression and depressive disorders, negative body image. Appropriate management requires a multi-disciplinary team of which the physiotherapist is a part of. Literature has shown that there is a better improvement in physical function if physiotherapy is commenced early. Therefore, physiotherapy should be incorporated pre and postmastectomy. Physiotherapy management should focus on lymphatic drainage, soft tissue mobilization, range of motion exercises, strengthening exercises and postural correction. Increased physical activity and recomm...
Pakistan BioMedical Journal
Breast cancer is ranked the top in types of cancer that affects internationally. It affects up to 1 in 13 women during their lifetime. Physiotherapy is one of the major sources of recovery in patients of Mastectomy in terms of pain, ranges, and function. OBJECTIVE: To compare the effects of pre-operative shoulder rehabilitation program versus post-operative mastectomy patients. METHODS: This was a randomized clinical trial. The study setting was Oncology Department, Mayo Hospital Lahore, Shokat Khanum and Gulab Devi Hospital Lahore. The study was completed in 6 months. Total 50 subjects were allocated in two groups using lottery method of randomization. Patient with age less than 40 years, diagnosed with breast cancer were included, while those with associated signs of musculoskeletal problems, autoimmune systemic disease and advanced medical problem was excluded. Group A received set of exercises comprised of range of motion exercises and lymph edema education pre and post operativ...
Background: Modified radical mastectomy is a frequent surgery employed as a therapeutic procedure in patients with breast carcinoma with involvement of axillary lymph nodes. Many patients suffer from severe shoulder complaints after axillary lymph node dissection even with postoperative rehabilitation. Pre-operative exercise and education are recommended to reduce the incidence of breast cancer related upper limb dysfunction; it will shorten the recovery time. The objectives of the study are to determine the influence of pre-operative physiotherapy on shoulder ROM using goniometer in subjects with modified radical mastectomy and to determine the influence of pre-operative physiotherapy on functional activities using shoulder pain and disability index (SPADI) in subjects with modified radical mastectomy. Methods: 30 Subjects of adult women included in the study who met the inclusion criteria, divided into 2 groups. Experimental Group received preoperative physical therapy education and exercises 1-2 weeks before surgery and routine physical therapy protocol after surgery. Control Group received standard education brochure preoperatively and routine physical therapy post operatively. Measurements included shoulder ROM and functional evaluation using goniometer and SPADI. Measurements were taken at baseline i.e., pre operatively, post operatively at 4th day after removal of drains, and 1month after surgery. Results: All measures were significantly reduced after surgery, but most recovered after 1month of surgery and attained functional level in experimental Group. Conclusion: This study provides experimental evidence that preoperative education and exercise influence the postoperative shoulder ROM and functional activities after modified radical mastectomy.
Journal of Forensic Medicine, 2021
Modified radical mastectomy performed for CA breast is a life modifying surgery for most women. It createsa profound impact on the quality of life enjoyed by the women. Body image in patients with breast cancerdiffers from all other cancers. The assessment of quality of life after modified radical mastectomy for earlybreast cancer patients using the World Health Organization Quality of Life-Brief Questionnaire (WHOQOLBREF) .Women suffers from day to day activities. Postures become impaired. Postural changes, such as increase inthoracic kyphosis , scoliosis leads to poor postural habits. There is also decrease in shoulder range of motion, scapular muscles weakness . Contractures may develop in axilla after surgery. Breast cancer survivors havemuscle weakness of upper limb are Pectoralis major, serratus anterior, upper trapezius, rhomboid muscles,latissimus dorsi .Spine alignment also may effect due to poor posture. Women with Modified Radical mastectomy may havesome social phobia . A...
Journal of Cancer Education, 2020
Breast cancer ranks highest in incidence and mortality among females and second among both genders. Lebanon has the second highest rate of breast cancer worldwide for those 35-39 years old and the highest for those 40-49. Mastectomy often results in deceased shoulder and arm mobility and decreased quality of life. The objective of this study was to assess the effect of an educational program of therapeutic exercises on the quality of life and functional ability in women after a mastectomy. Sixty women undergoing a mastectomy were randomly assigned to either an intervention or control group. The intervention group received extensive pre-surgery education as well as training on therapeutic exercises. Follow-up phone calls to the intervention group were made to ensure that the exercises were being done. Both groups were visited at home at two and four weeks to obtain the outcome variables. The Breast Cancer Patient Version was used to assess quality of life, and the "Goniometer" was used to assess the range of motion of the affected shoulder. At two and four weeks after surgery, women in the intervention group had significant improvements in their shoulder range of motion: flexion, extension, and abduction were significantly different between the control and intervention group at p = 0.04-0.00. For quality of life, physical, psychological, psychological, social, and spiritual well-being were significantly higher for the intervention group at both two and four weeks after surgery, p < 0.001. In a middle-income country, one-to-one education provided by a nurse, which included demonstrations, back demonstrations, and weekly phone calls had a positive impact on women's shoulder range of motion and quality of life. NCT04184102