The impact of sensory alterations on upper limb function after a mastectomy

Abstract

Realizar a análise descritiva do perfil físico e clínico de mulheres após mastectomia, além de verificar a funcionalidade do membro superior homolateral à cirurgia e avaliar quais os domínios do questionário de qualidade de vida têm repercussões na capacidade funcional desse segmento corporal. Métodos: Estudo descritivo de corte transversal, realizado no Centro de Oncologia Dr. Muccini, em Petrolina (PE), com a participação de 53 pacientes. A funcionalidade do membro superior homolateral à cirurgia foi mensurada por meio do questionário Disability of the Arm, Shoulder and Hand (DASH) e a qualidade de vida por meio do European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) e seu módulo específico para câncer de mama (EORTC-QLQ-BR23). Resultados: A sintomatologia teve impacto importante na função dos membros superiores das pacientes, uma vez que foram verificadas correlações estatisticamente significativas (p<0,05) entre o escore total do DASH com a sintomatologia (r=0,451 no QLQ-C30 e r=0,535 no QLQ-BR23) e a funcionalidade (r=-0,488 e r=-0,448), sendo estas negativas. Foi também verificada associação estatisticamente significante (p=0,001) entre limitação nas atividades da vida diária (AVDs) e presença subjetiva de linfedema. Conclusão: As alterações sensitivas decorrentes da mastectomia são as principais responsáveis pelo desenvolvimento de modificações que afetam a funcionalidade do membro superior homolateral à cirurgia. A sensação subjetiva de linfedema teve associação com limitações nas AVDs e redução da capacidade funcional do braço.

Effect of Conservative Rehabilitation Interventions on Health-Related Quality of Life in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Systematic Review

“…Although lymphedema can appear in various areas, such as the breast, armpit, chest, or back, it most commonly appears in the upper extremity on the affected side [ 6 ], presenting various symptoms such as swelling, pain, discomfort, tightness, hypersensitivity, or lack of sensation. In this way, dermatological alterations, sleep disorders, limitations in performing activities of daily living, dissatisfaction with body image, interference with social function, and even anxiety and depression can appear, considerably reducing the health-related quality of life (HRQoL) of patients with BCRL [ 7 , 8 , 9 ].…”

Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer—A Randomized Clinical Trial

“…It is a chronic and progressive condition, in which insufficient drainage of lymphatic fluid causes swelling and alterations in the upper extremity on the side of the breast in treatment and in functions related to skin, energy and impulses, sexuality, sleep, temperament and personality, as well as in additional sensory functions such as proprioceptive and tactile functions. All these alterations limit the performance of activities and restrict participation in daily situations, decreasing the health-related quality of life (HRQoL) of people suffering from this disorder [ 1 , 2 , 3 , 4 ].…”

Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial

“…BCRL can lead to inflammatory complications that cause skin hardening that can break and leave the area exposed to frequent infections, which worsen the BCRL. There may be an alteration of the patient's sensitivity to touch and kinesthetics, their sexuality perception, self-image problems, decreased levels of physical activity, fatigue, psychological distress, limitations in the strength, endurance and active range of motion of the upper limbs and other sensations related to pain, swelling and heaviness, which decrease the functionality of the affected arm [5][6][7][8][9][10].…”