Morbidity after breast cancer treatment and physiotherapeutic performance

Gomide, Liana Barbaresco; Matheus, João Paulo Chieregato; Reis, Francisco José Candido dos

doi:10.1111/j.1742-1241.2006.01152.x

Cited by 37 publications

(30 citation statements)

References 169 publications

(258 reference statements)

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“…Surgery and treatments for breast cancer may lead to upper extremity impairments, functional limitations and disabilities such as pain, stiffness, lymphedema, cording, decreased strength and range of motion (ROM) and decreased activity tolerance [1][2][3][4]. Patients post mastectomy surgery tends to experience a protracted recovery time and more functional impairments than those with breast conservation therapy [2,[5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Predictors of functional shoulder recovery at 1 and 12 months after breast cancer surgery

Levy

Pfalzer

Danoff

et al. 2012

Breast Cancer Res Treat

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The objective of this study are (1) to determine if upper extremity function, as represented by shoulder ROM, self-reported symptoms and upper extremity functional limitations in activities of daily living could be predictively related to demographic and cancer characteristics post-surgery for breast cancer. And (2) to examine if variables related to early onset impairment contribute to late onset impairments in women after breast cancer surgery. Subjects were assessed preoperatively and 1, 3, 6, 9, and 12+ months post breast cancer surgery for impairments and symptoms and at 12+ months for shoulder functional limitations using a physical therapy surveillance model. Body weight, shoulder ROM, manual muscle testing, and upper limb volume were recorded. At 12+ months, the Harvard Alumni Health Study Physical Activity Questionnaire, and an Upper Limb Disability Questionnaire were administered. Symptoms and ROM impairments were compared by functional limitations. Characteristics significantly associated with early ROM impairment (but not later impairment) were axillary lymph node dissection, removal of ≥15 nodes, mastectomy surgery and stage II breast cancer. Positive nodes, older age, and BMI≥25 were significantly associated with reduced shoulder ROM at 12+ months. At 12+ months, only 10 % of the patients experienced ROM impairments while rates of self-reported symptoms in the affected upper extremity at 12+ months were as follows: pain-49%, weakness-47.1%, numbness-55.9%, feeling tired-42.5%. The majority of patients used the affected upper extremity for reaching without limitation, but ≥35% reported limitation with household chores, carrying and lifting. Difficulty carrying and lifting could be predicted by BMI≥25 and use of the dominant affected upper limb. Different factors are associated with early versus later ROM loss. Symptoms reported by breast cancer survivors are frequently associated with functional limitations in upper extremity tasks and warrant intervention. Physical therapy using a prospective surveillance model of care may reduce severity of ROM loss, symptoms and functional upper extremity limitations 1 year after breast cancer surgery.

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Section: Introductionmentioning

confidence: 99%

Predictors of functional shoulder recovery at 1 and 12 months after breast cancer surgery

Levy

Pfalzer

Danoff

et al. 2012

Breast Cancer Res Treat

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“…Pektoral, uzun torasik ve torakodorsal sinirlerin hasarı sırasıyla pektoral kasların atrofisi, kanat skapula ve latissimus dorsi kasının atrofisine neden olabilmektedir. RT sonrası hareket kısıtlılığı, subkutan fibrozis nedeniyle derin kaslara olan fiksasyon sonucunda oluşabilmektedir (32 Beaulac ve ark. (16) yaşam kalitesi olarak FACT-B ölçeğini kullandıklarında, operasyon tipi, hastalık evresi, KT, yaş, operasyon sonrası geçen süre ile total FACT-B skor arasında anlamlı ilişki bulmadıklarını bildirmişlerdir.…”

Section: Discussionunclassified

Meme Cerrahisi ve Aksiller Diseksiyon Uygulanan Meme Kanserli Hastalarda Üst Ekstremite Problemlerinin Sıklığı ve Yaşam Kalitesine Etkisi

Atalay¹

2013

Tftr

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Sum maryAim: The purpose of this study was to determine the prevalence of upper extremity problems in patients who had undergone breast cancer surgery, to compare the risk factors associated with these problems and to investigate their effects on quality of life. Materials and Methods: One hundred thirty-two patients who had undergone either modified radical mastectomy or breast conserving surgery (lumpectomy) were enrolled to the study. Lymphedema, shoulder pain and restriction of shoulder motion were considered as upper extremity problems. Type of surgery, body mass index (BMI), radiotherapy, chemotherapy, disease stage and dominant hand involvement were recorded. The World Health Organisation (WHO) Quality of Life-BREF-Turkish Version (WHOQOL-BREF-TR) was used for the assessment of quality of life. Results: Shoulder pain was the most common symptom (45.5%), followed by lymphedema (34.8%) and shoulder motion restriction (22%). No significant relation was found between lymphedema and age, type of surgery, restriction of shoulder motion, pain and dominant hand involvement. Increased BMI, treatment with chemotherapy or radiotherapy, advanced-disease stage and lymph node involvement were associated with lymphedema (p< 0.05). It was seen that doing regular exercise had positive effect on lymphedema, pain and shoulder motion restriction reduction ( p<0.05). Lymphedema, pain and shoulder motion restriction were related with physical and psychological subgroups of WHOQOL-BREF TR, whereas shoulder motion restriction was also associated with the environmental subgroup (p<0.05). When Özet Amaç: Bu çalışmanın amacı meme kanseri nedeniyle cerrahi uygulanan hastalarda üst ekstremite problemlerinin görülme sıklığının saptanması, bu problemlerle ilişkili risk faktörlerinin karşılaştırılması ve yaşam kalitesi üzerine etkilerini araştırmaktır. Gereç ve Yöntem: Modifiye radikal mastektomi veya meme koruyucu cerrahi (lumpektomi) uygulanan 132 hasta çalışmaya dahil edildi. Üst ekstremite problemleri olarak lenfödem, omuz ağrısı, omuz hareket kısıtlılığı değerlendirildi. Ayrıca operasyon şekli, vücut kitle indeksi (VKİ), kemoterapi (KT), radyoterapi (RT), hastalık evresi, lenf nodu tutulumu, yaş, dominant elin tutulumu kaydedildi. Yaşam kalitesi ölçeği olarak Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği Türkçe kısa formu (WHOQOL-BREF TR) kullanıldı. Bulgular: Hastalarda en sık görülen semptom olan omuzda ağrıyı (%45,5), lenfödem (%34,8) ve omuzda hareket kısıtlılığı (%22) takip etmekteydi. Yaş, operasyon şekli, omuzda hareket kısıtlılığı, ağrı varlığı ve dominant elin tutulumu ile lenfödem arasında anlamlı ilişki saptanmazken, artmış VKİ, KT-RT tedavisi almış olma, ileri hastalık evresi, lenf nodu tutulumu varlığı lenfödem olan grupta daha yüksekti (p<0,05). Düzenli egzersiz yapmanın lenfödem, ağrı ve hareket kısıtlılığını azaltma yönünde etkili bir faktör olduğu görüldü (p<0,05). Lenfödem, ağrı ve omuz hareket kısıtlılığının WHOQOL-BREF TR'nin bedensel, ruhsal alt alanları üzerine, omuz hareket kısıtlılığının ayrıca çevre alt alanı ü...

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“…For survivors of breast cancer, physical therapy has been shown to reduce pain and restore shoulder range of motion, muscle strength, and posture. 10,11 Dyspnea, or shortness of breath, is a distressing and debilitating symptom that may be directly related to primary or metastatic lung cancer. 12 Indirect causes of dyspnea include treatmentrelated side effects from radiation therapy (e.g., pneumonitis) or chemotherapy (e.g., pulmonary toxicity) and secondary effects of cancer treatment such as anaemia, cachexia, pulmonary embolism, and anxiety.…”

Section: The Need For Cancer Rehabilitation Programmesmentioning

confidence: 99%

Clinician's Commentary on Canestraro et al.

McNeely¹

2013

Physiotherapy Canada

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Morbidity after breast cancer treatment and physiotherapeutic performance

Cited by 37 publications

References 169 publications

Predictors of functional shoulder recovery at 1 and 12 months after breast cancer surgery

Predictors of functional shoulder recovery at 1 and 12 months after breast cancer surgery

Meme Cerrahisi ve Aksiller Diseksiyon Uygulanan Meme Kanserli Hastalarda Üst Ekstremite Problemlerinin Sıklığı ve Yaşam Kalitesine Etkisi

Clinician's Commentary on Canestraro et al.

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