The Sequelae of Mastectomy and Quadrantectomy Respect to the Reaching Movement in Breast Cancer Survivors

University of Roma La Sapienza

Status

Completed

Conditions

Breast Cancer

Pain, Postoperative

Pain, Chronic

Mastectomy; Lymphedema

Treatments

Other: Rehabilitation protocol

Study type

Interventional

Funder types

Other

Identifiers

NCT04145739

URomLS-2019

Details and patient eligibility

About

The hypothesis behind our study was that patients after BC surgery, who underwent quadrantectomy or mastectomy, may present a different disability respect to the upper limb on the operated side. Accordingly they could have a different functional recovery patterns after rehabilitation.

The aim of our study was to compare the recovery of the fluidity of the reaching movement (Jerk) as the primary outcome, the reduction of shoulder pain and improvement of disability for the upper limb respect the operated side as secondary outcomes, before and after a specific rehabilitation protocol treatment.

Full description

Surgery is usually the first line of attack against breast cancer (BC). The decisions about surgery depend on many factors based on the stage, the type of cancer and patient acceptability, in terms of her long term peace of mind and survival prospects. Typically, breast reconstruction takes place during or soon after mastectomy, to avoid psychological distress for the patient, and in some cases, also after lumpectomy or quadrantectomy; furthermore breast reconstruction can be done many months or even years after surgery too.

Today, breast cancer rehabilitation can help survivors to obtain and maintain the highest possible physical, social, psychological and vocational functioning, within the limits created by cancer and its treatments. After BC surgery, is common to detect disorders as shoulder dysfunction, postmastectomy syndrome, chemotherapy-induced peripheral neuropathy, axillary cording, lymphedema and a host of others as postural imbalance.

Also, alterations in muscle activation and restricted shoulder mobility, which are common in BC patients, have been found to affect upper limb function and alterations in muscle activity patterns differed by breast surgery and reconstruction type: rehabilitation and in particular mobilization stretches and shoulder and scapula exercises after breast surgery are an effective resource to improve upper limb range of motion and decrease chest tightness and pain.

This study was prompted by the lack of literature about the quadrantectomy versus mastectomy intervention, considering the disability of the upper limb from the operated side, especially if in relation to the rehabilitation pathway, currently recommended in BC care.

Enrollment

65 patients

Sex

Female

Ages

18 to 60 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

total mastectomy with breast prostheses or tissue expanders performed or quadrantectomy
age from 18 to 60 years
body mass index (BMI) < 30
no cognitive dysfunctions ( Mini Mental State Examination MMSE > 24)
mild lymphedema

Exclusion criteria

presence of lymphangitis or mastitis
presence of metastasis
surgical complications of the intervention, neurological deficits and complications
important shoulder joint problems before the intervention for BC
severe-moderate lymphedema and web axillary syndrome
visual problem not corrected by lenses
other or previous physiotherapy