/ Derleme An Evaluation of the Current Rehabilitation Methods for Women with Breast Cancer (original) (raw)
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Introduction. The most common functional complications after the treatment of breast cancer are reduction of range of motion in the shoulder joint (incidence of 10 to 73%), lymphedema of the arm (10-30%) and nerve damage of the arm or damage of brachial plexus (1.8-4.9%). Multiple complications rarely occur and they are usually of mild to moderate forms. Case report. VV (woman), born in 1965 was exposed to quadrantectomy of the left breast with axillary dissection in 2003 (histopathology: ductal carcinoma; 4 removed lymph nodes, 1 of which with a secondary deposit). After the surgical intervention, the patient underwent chemotherapy (CMF protocol VI cycles) and radiation therapy (50 Gy/12 cycles). Four months after the therapy completion, lymphedema of the left arm was developed, and few months later brachial plexus injury as well. First visit to physiatrist was five years later, with a significant reduction of range of motion in the left arm and severe lymphedema (maximum difference to 7.5 cm). EMNG trial indicated a moderate le-sion of left median nerve and ulnar nerve and mild to moderate lesion of left radial nerve injury; DASH score was 107. After repeated physical treatments (since 2009), the last control in October 2016 showed that the functional status was significantly improved: reduction of range of motion was present in flexion and abduction only, lymphedema was reduced (maximum difference of 5.5 cm); DASH score was 48, while EMNG indicated a lesion of the median nerve and ul-nar nerve in lower level, with signs of recovery. Conclusion. The implementation of an early rehabilitation program for the patients who were surgically treated for breast cancer is necessary in order to prevent functional complications and to enable continuous monitoring of the patients, while in the case with already developed complications, physical therapy should be initiated regardless of the period in which the functional limitations occurred.
The importance of rehabilitation in the treatment of breast cancer
2014
Mastectomy due to breast cancer results in many problems and physical dysfunctions related with the constant necessity to protect the upper extremity at the site of the operated breast, and application of a specialist physiotherapeutic procedure. Rehabilitation is an integral part of the process of breast cancer treatment, and its primary goal is the limitation of selected physical, psychological, and social consequences of this cancerous disease. The achievement of rehabilitation goals requires teamwork – the simultaneous solving of problems in various spheres of the patient’s life. This work should be considered as overall care activity concerning a human being according to a holistic approach. A very important element of rehabilitation after mastectomy is to reassure the patient that with the help of specialists she can overcome difficulties, solve her problems, and return to normal daily life.
Physiotherapy Rehabilitation in Patients with Breast Cancer -A Case Report
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.3\_March2022/IJHSR-Abstract.020.html, 2022
Breast cancer has been the most common cancer in the United Kingdom since 1997, accounting for 31% of all new cancer diagnoses in women. The rate of new diagnoses among people over 40 years old rises fast, from under 1 per 100,000 in young adults to well over 400 per 100,000 in those over 85 years old (1). Breast cancer survival rates are improving as a result of breakthroughs in diagnosis and therapy, and cancer survivorship has emerged as a major focus in the cancer care continuum. (2). Cancer rehabilitation is defined as the process of aiding a patient in attaining the best level of physical, psychological, social, sexual, vocational, recreational, and economic functioning possible within the restrictions of the disease and therapy. (2). Pain, lymphedema, secondary malignancies, and sexual dysfunction are among the possible long-term physical repercussions of cancer (2). Fear and anxiety about return of cancer, sadness, and emotions of uncertainty and loneliness are all possible psychological consequences. (2). Changes in interpersonal connections, financial and health insurance concerns and difficulty returning to work or seeking employment owing to impairment are all examples of social impacts (2). Even though recent advancements in therapy have increased survival rates, they are also associated with considerable adverse effects (3). Breast cancer survival rates have increased as a result of breakthroughs in early detection procedures, followed by more tailored and/or aggressive therapy (3). Although breast cancer patients' rehabilitation has become a priority in recent years, additional research on the most effective sorts of therapies is still needed. (3).
Topics in Geriatric Rehabilitation, 2015
Breast cancer is the most commonly diagnosed cancer in women in the United States. The treatment for breast cancer occurs along a protracted time period and includes many different disease treatment modalities. These treatments carry with them a large number of side effects that negatively impact function in both the short-term and long-term. It is necessary for rehabilitation providers to interface with patients being treated for breast cancer throughout the continuum of care so that interval assessments can be conducted to identify emerging impairments and alleviate disability. In order to achieve this, the rehabilitation provider must have an understanding of the clinical measurement tools best suited for examination and assessment of breast cancer-related impairments and disability. This article aims to provide a comprehensive overview of the evidence supporting the use of various clinical measurement tools for the breast cancer population and highlights the implementation of rehabilitation examination and assessment along the continuum of disease treatment.
Breast cancer rehabilitation method - a systematic review
Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, ‘therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’. Study selection: Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review. Data extraction: Included review year, study aim, total number of participants included, and results. Data synthesis: Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods) for addressing the domains of psychosocial, cognitive, and occupational outcomes. Conclusion: There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients’ self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years.
Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, 'therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’. Study selection: Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review. Data extraction: Included review year, study aim, total number of participants included, and results. Data synthesis: Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods) for addressing the domains of psychosocial, cognitive, and occupational outcomes. Conclusion: There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients’ self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years. Keywords: breast cancer surgery, rehabilitation methods, symptom-management, quality of life, lifestyle redesign, self-management
European journal of physical and rehabilitation medicine, 2012
Breast cancer (BC) is currently the most frequent tumor in women. Through the years, BC management has evolved towards conservative surgery. However, even minimally invasive surgery can cause neuromotor and/or articular impairments which can lead to permanent damage, if not adequately treated. To clinically evaluate upper ipsilateral limb function and the impact of certain post-surgical consequences arising after invasive or breast-conserving surgery for early BC, by intervening, or not intervening, with an early rehabilitation program. To investigate physical morbidity after sentinel (SLND) or axillary lymph node dissection (ALND) and after reconstructive surgery in the treatment of early BC. Observational prospective trial. Inpatient and outpatient treatment. Eighty-three females participated in the study: 25 patients did not begin physiotherapy during hospitalization (Group A), 58 patients received early rehabilitation treatment (Group B). The patients of Groups A and B were comp...
Physical rehabilitation after breast cancer
Translational Cancer Research
Assessment, prevention and early diagnosis of breast cancer-related lymphedema (BCRL) Detection and management of early-stage BCRL may prevent progression to chronic disabling disease and may enable cost-effective conservative interventions (1). Lymphedema is a condition characterized by accumulation of protein-rich tissue fluid in extravascular interstitial spaces that causes edema, due to the impairment of lymphatic system, producing chronic inflammation with pain, tightness and heaviness in the arm. Patients at high-risk for BCRL have history of axillary lymph-node dissection (ALND), regional nodal irradiation, taxane-based chemotherapy, increased BMI, and cellulitis. Surveillance and regular follow up reduce BCRL risk in these patients (1). Pathophysiology of BCRL shows an acute and chronic phase with different stages (2): Stage 0 or latent stage of BCRL, the accumulation of fluid may not be evident with subclinical volume accumulation Stage I with clinically palpable lymphedema, that disappears with elevation of the limb and it is characterized by a lack of fibrosis. Subsequently, intradermal fibrosis is an irreversible and chronic phase of BCRL lasting more than 3 months. Stage II lymphedema no longer pits on pressure because of excess fat deposition and tissue fibrosis and no longer reverses with elevation. Stage III lymphedema has progressive swelling with trophic skin changes, including papules, warts, skin folds, tissue bulges, and often open draining wounds, leading to severe impairment in mobility and high risk of infection (3). Diagnostic techniques for BCRL have developed with increased sensitivity, allowing for subclinical detection and early treatment (4). Pre and postoperative circumferential measurements of both arms should be taken at 4 points (the metacarpal-phalangeal joints, the wrists, 10 cm distal to the lateral epicondyles, and 12 cm proximal to the lateral epicondyles). A difference of more than 2.0 cm at any of the 4 measurement points means the needs of BCRL treatment. It is important to keep attention to symptoms of heaviness,
A prospective model of care for breast cancer rehabilitation: Bone health and arthralgias
Cancer, 2012
A significant proportion of adult breast cancer survivors experience deficits in function and restriction in participation in life roles that may remain many years after diagnosis. Function is a complex construct that takes into account the interactions between an individual, their health condition, and the social and personal context in which they live. Research to date on limitations in activities of daily living, upper extremity function, and functional capacity in breast cancer survivors illustrates the need for prospective measurement of function using measures that are sensitive to the unique issues of breast cancer survivors and the need for the development of effective rehabilitation interventions to improve function. Limitations in function have a significant impact on quality of life, but less is known about the implications on return to work and survival, as well as the impact of other comorbidities and aging on the function limitations in breast cancer survivors. This review provides a rationale for the integration of measures of function into breast cancer care to more fully appreciate the functional limitations associated with breast cancer diagnosis and treatment and to aid in the development of better rehabilitation care for breast cancer survivors. Cancer 2012;118(8 suppl):2300-11.