Physiotherapy in the prevention and treatment of upper limb complications in women with breast cancer

Main Article Content

Taynara Louisi Pilger
https://orcid.org/0000-0003-2622-2819
Anna Julia Matheus Ortolani
https://orcid.org/0000-0003-3284-3777
Francisco José Candido dos Reis Reis
https://orcid.org/0000-0001-5758-5917

Abstract

Breast cancer is the one that most affects the female population in Brazil and the world. Upper limb complications are common after cancer treatment, including conservative procedures. Old studies have already shown the effectiveness of physiotherapy in the rehabilitation of these complications. However, currently, physiotherapeutic care must be initiated from the diagnosis of the disease. Pre-rehabilitation prepares the patient to receive cancer treatment and promotes a reduction in rehabilitation time. Rehabilitation decreased the axillary cord by 57%, increased the range of motion (ROM) by 45º for flexion and 70º for shoulder abduction, the incidence of lymphedema was 11%, and there was a decrease of 3.4 points concerning pain on the Visual Scale Analog (EVA). The physical therapist should work with breast cancer to diagnose, prevent, and rehabilitate after cancer treatment, promoting functionality and quality of life for patients with breast cancer.



Article Details

How to Cite
1.
Pilger TL, Ortolani AJM, Reis FJC dos R. Physiotherapy in the prevention and treatment of upper limb complications in women with breast cancer. HSJ [Internet]. 2022 Jun. 28 [cited 2024 Nov. 22];12(2):3-11. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1249
Section
NARRATIVE REVIEW
Author Biographies

Taynara Louisi Pilger, Faculty of Medicine of Ribeirão Preto

Doctoral student in Gynecology and Obstetrics at the Faculty of Medicine of Ribeirão Preto.

Anna Julia Matheus Ortolani, Faculty of Medicine of Ribeirão Preto.

Student of the 2nd year of Physiotherapy at the Faculty of Medicine of Ribeirão Preto.

Francisco José Candido dos Reis Reis, Faculdade de Medicina de Ribeirão Preto

Master's (1997) and Doctorate (1999) in Gynecology and Obstetrics at the University of São Paulo (FMRP-USP). Postdoctoral fellow at Brigham and Womens Hospital at Harvard Medical School in Boston (2004-2005) and Visiting Research Fellow at the Center for Cancer Genetic Epidemiology at Cambridge University in the UK (2013-2015). Associate professor (level III) at FMRP-USP.

References

INCA. Estimativa 2020: incidência de câncer no Brasil [Internet]. INCA - Instituto Nacional de Câncer. 2019 [updated 2020 Apr 29; cited 2022 Jun 1]. Available from: https://www.inca.gov.br/publicacoes/livros/estimativa-2020-incidencia-de-cancer-no-brasil

World Health Organization. Cancer today [Internet]. Data visualization tools for exploring the global cancer burden in 2020 [cited 2022 Jun 1]. Available from: http://gco.iarc.fr/today/home

Peto R, Boreham J, Clarke M, Davies C, Beral V. UK and USA breast cancer deaths down 25% in year 2000 at ages 20-69 years. Lancet. 2000;355(9217):1822. https://doi.org/10.1016/S0140-6736(00)02277-7

Pilger TL, Francisco DF, Candido Dos Reis FJ. Effect of sentinel lymph node biopsy on upper limb function in women with early breast cancer: A systematic review of clinical trials. Eur J Surg Oncol. 2021;47(7):1497-506. https://doi.org/10.1016/j.ejso.2021.01.024

Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233-41. https://doi.org/10.1056/NEJMoa022152

Le Dran HF, Académie royale de chirurgie (France). Mémoire avec un précis de plusieurs observations sur le cancer [Book]. Paris: [publisher not identified]; 1757.

Qiu SQ, Zhang GJ, Jansen L, de Vries J, Schröder CP, de Vries EGE, et al. Evolution in sentinel lymph node biopsy in breast cancer. Crit Rev Oncol Hematol. 2018;123:83-94. https://doi.org/10.1016/j.critrevonc.2017.09.010

Castaneda SA, Strasser J. Updates in the treatment of breast cancer with radiotherapy. Surg Oncol Clin N Am. 2017;26(3):371-82. https://doi.org/10.1016/j.soc.2017.01.013

Vugts G, Maaskant-Braat AJG, Nieuwenhuijzen GAP, Roumen RMH, Luiten EJT, Voogd AC. Patterns of care in the administration of neo-adjuvant chemotherapy for breast cancer. A population-based study. Breast J. 2016;22(3):316-21. https://doi.org/10.1111/tbj.12568

Chrischilles EA, Riley D, Letuchy E, Koehler L, Neuner J, Jernigan C, et al. Upper extremity disability and quality of life after breast cancer treatment in the Greater Plains Collaborative clinical research network. Breast Cancer Res Treat. 2019;175(3):675-89. https://doi.org/10.1007/s10549-019-05184-1

Lee TS, Kilbreath SL, Refshauge KM, Herbert RD, Beith JM. Prognosis of the upper limb following surgery and radiation for breast cancer. Breast Cancer Res Treat. 2008;110(1):19-37. https://doi.org/10.1007/s10549-007-9710-9

Ashikaga T, Krag DN, Land SR, Julian TB, Anderson SJ, Brown AM, et al. Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection. J Surg Oncol. 2010;102(2):111-8. https://doi.org/10.1002/jso.21535

DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 2013;14(6):500-15. https://doi.org/10.1016/S1470-2045(13)70076-7

Shah C, Vicini FA. Breast cancer-related arm lymphedema: incidence rates, diagnostic techniques, optimal management and risk reduction strategies. Int J Radiat Oncol Biol Phys. 2011;81(4):907-14. https://doi.org/10.1016/j.ijrobp.2011.05.043

Shaitelman SF, Chiang YJ, Griffin KD, DeSnyder SM, Smith BD, Schaverien MV, et al. Radiation therapy targets and the risk of breast cancer-related lymphedema: a systematic review and network meta-analysis. Breast Cancer Res Treat. 2017;162(2):201-15. https://doi.org/10.1007/s10549-016-4089-0

Ugur S, Arıcı C, Yaprak M, Mescı A, Arıcı GA, Dolay K, et al. Risk factors of breast cancer-related lymphedema. Lymphat Res Biol. 2013;11(2):72-5. https://doi.org/10.1089/lrb.2013.0004

Soyder A, Taştaban E, Özbaş S, Boylu Ş, Özgün H. Frequency of early-stage lymphedema and risk factors in postoperative patients with breast cancer. J Breast Health. 2014;10(2):92-7. https://doi.org/10.5152/tjbh.2014.1973

Langford DJ, Schmidt B, Levine JD, Abrams G, Elboim C, Esserman L, et al. Preoperative breast pain predicts persistent breast pain and disability after breast cancer surgery. J Pain Symptom Manage. 2015;49(6):981-94. https://doi.org/10.1016/j.jpainsymman.2014.11.292

Gärtner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA. 2009;302(18):1985-92. https://doi.org/10.1001/jama.2009.1568

Andersen KG, Kehlet H. Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. J Pain. 2011;12(7):725-46. https://doi.org/10.1016/j.jpain.2010.12.005

Leysen L, Beckwée D, Nijs J, Pas R, Bilterys T, Vermeir S, et al. Risk factors of pain in breast cancer survivors: a systematic review and meta-analysis. Support Care Cancer. 2017;25(12):3607-43. https://doi.org/10.1007/s00520-017-3824-3

Santos MSMD, Panobianco MS, Mamede MV, Meirelles MCCC, Barros VME. [Tactile sensibility in arm of women subjected to the axillary lymph node dissection for breast cancer]. Rev Bras Ginecol Obstet. 2009;31(7):361-6. https://doi.org/10.1590/S0100-72032009000700007

Bezerra TS, Rett MT, Mendonça ACR, Santos DE, Prado VM, DeSantana JM. Hipoestesia, dor e incapacidade no membro superior após radioterapia adjuvante no tratamento para câncer de mama. Rev dor. dezembro de 2012;13:320-6. https://doi.org/10.1590/S1806-00132012000400003

Blomqvist L, Stark B, Engler N, Malm M. Evaluation of arm and shoulder mobility and strength after modified radical mastectomy and radiotherapy. Acta Oncol. 2004;43(3):280-3. https://doi.org/10.1080/02841860410026170

Pillai US, Kayal S, Cyriac S, Nisha Y, Dharanipragada K, Kamalanathan SK, et al. Late Effects of Breast Cancer Treatment and Outcome after Corrective Interventions. Asian Pac J Cancer Prev. 2019;20(9):2673-9.

https://doi.org/10.31557/APJCP.2019.20.9.2673

Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ. Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast Cancer Res Treat. 2016;159(2):327-33. https://doi.org/10.1007/s10549-016-3939-0

Fougo JL, Dinis-Ribeiro M, Araújo C, Dias T, Reis P, Giesteira L, et al. Impacto de la linfadenectomía sobre la recurrencia axilar y la morbilidad del miembro superior en pacientes con cáncer de mama y ganglio centinela negativo: Estudio prospectivo aleatorizado. Cir Esp. 2011;89(5):307-16. Spanish. https://doi.org/10.1016/j.ciresp.2011.01.011

Yang S, Park DH, Ahn SH, Kim J, Lee JW, Han JY, et al. Prevalence and risk factors of adhesive capsulitis of the shoulder after breast cancer treatment. Support Care Cancer. 2017;25(4):1317-22. https://doi.org/10.1007/s00520-016-3532-4

Silver JK, Baima J. Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes. Am J Phys Med Rehabil. 2013;92(8):715-27. https://doi.org/10.1097/PHM.0b013e31829b4afe

Campbell KL, Pusic AL, Zucker DS, McNeely ML, Binkley JM, Cheville AL, et al. A prospective model of care for breast cancer rehabilitation: function. Cancer. 2012;118(8 Suppl):2300-11. https://doi.org/10.1002/cncr.27464

Nilsson H, Angerås U, Bock D, Börjesson M, Onerup A, Fagevik Olsen M, et al. Is preoperative physical activity related to post-surgery recovery? A cohort study of patients with breast cancer. BMJ Open. 2016;6(1):e007997. https://doi.org/10.1136/bmjopen-2015-007997

Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, Prieto Merino D, Mayoral del Moral O, Cerezo Téllez E, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010;340:b5396. https://doi.org/10.1136/bmj.b5396

Lu SR, Hong RB, Chou W, Hsiao PC. Role of physiotherapy and patient education in lymphedema control following breast cancer surgery. Ther Clin Risk Manag. 2015;11:319-27. https://doi.org/10.2147/TCRM.S77669

Stanton AW, Badger C, Sitzia J. Non-invasive assessment of the lymphedematous limb. Lymphology. 2000;33(3):122-35. PMID: 11019400

Chen YW, Tsai HJ, Hung HC, Tsauo JY. Reliability study of measurements for lymphedema in breast cancer patients. Am J Phys Med Rehabil. 2008;87(1):33-8. https://doi.org/10.1097/PHM.0b013e31815b6199

Scrimshaw SV, Maher C. Responsiveness of visual analogue and McGill pain scale measures. J Manipulative Physiol Ther. 2001;24(8):501-4. https://doi.org/10.1067/mmt.2001.118208

Suda M, Kawakami M, Okuyama K, Ishii R, Oshima O, Hijikata N, et al. Validity and Reliability of the Semmes-Weinstein Monofilament Test and the Thumb Localizing Test in patients with stroke. Front Neurol. 2021;11:625917. https://doi.org/10.3389/fneur.2020.625917

Gandbhir VN, Cunha B. Goniometer. [Updated 2021 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558985

Cronin J, Lawton T, Harris N, Kilding A, McMaster DT. A Brief review of handgrip strength and sport performance. J Strength Cond Res. 2017;31(11):3187-217. https://doi.org/10.1519/JSC.0000000000002149

Gordon LG, Battistutta D, Scuffham P, Tweeddale M, Newman B. The impact of rehabilitation support services on health-related quality of life for women with breast cancer. Breast Cancer Res Treat. 2005;93(3):217-26. https://doi.org/10.1007/s10549-005-5151-5

Beurskens CHG, van Uden CJT, Strobbe LJA, Oostendorp RAB, Wobbes T. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study. BMC Cancer. 2007;7:166. https://doi.org/10.1186/1471-2407-7-166

Hasenoehrl T, Keilani M, Palma S, Crevenna R. Resistance exercise and breast cancer related lymphedema - a systematic review update. Disabil Rehabil. 2020;42(1):26-35. https://doi.org/10.1080/09638288.2018.1514663

Rangon FB, da Silva J, Dibai-Filho AV, Guirro RRJ, Guirro ECO. Effects of Complex Physical Therapy and multimodal approaches on lymphedema secondary to breast cancer: a systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil. 2022;103(2):353-63. https://doi.org/10.1016/j.apmr.2021.06.027

Panchik D, Masco S, Zinnikas P, Hillriegel B, Lauder T, Suttmann E, et al. Effect of exercise on breast cancer-related lymphedema: what the lymphatic surgeon needs to know. J Reconstr Microsurg. 2019;35(1):37-45. https://doi.org/10.1055/s-0038-1660832

Serra-Añó P, Inglés M, Bou-Catalá C, Iraola-Lliso A, Espí-López GV. Effectiveness of myofascial release after breast cancer surgery in women undergoing conservative surgery and radiotherapy: a randomized controlled trial. Support Care Cancer. 2019;27(7):2633-41. https://doi.org/10.1007/s00520-018-4544-z

Bailey LB, Thigpen CA, Hawkins RJ, Beattie PF, Shanley E. Effectiveness of manual therapy and stretching for baseball players with shoulder range of motion deficits. Sports Health. 2017;9(3):230-7. https://doi.org/10.1177/1941738117702835

Novak CB, von der Heyde RL. Evidence and techniques in rehabilitation following nerve injuries. Hand Clinics. 2013;29(3):383-92. https://doi.org/10.1016/j.hcl.2013.04.012

Nogueira PVG. Efeitos da facilitação neuromuscular proprioceptiva na performance funcional de mulheres mastectomizadas. Fisioter Bras [Internet]. 2005 [cited 2022 Jun 1];6(1):28-35. Available from: https://bit.ly/3NP6zSs

INCA - Instituto Nacional de Câncer. Atividade Física [Internet]. 2021 [updated 2020 Apr 14; cited 2022 jun 1]. Available from: https://bit.ly/395Zm1r

Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncol. 2015;54(5):635-54. https://doi.org/10.3109/0284186X.2014.998275

Farmer GD, Pearson M, Skylark WJ, Freeman ALJ, Spiegelhalter DJ. Redevelopment of the Predict: Breast Cancer website and recommendations for developing interfaces to support decision-making. Cancer Med. 2021;10(15):5141-53. https://doi.org/10.1002/cam4.4072

Box RC, Reul-Hirche HM, Bullock-Saxton JE, Furnival CM. Physiotherapy after breast cancer surgery: results of a randomised controlled study to minimise lymphoedema. Breast Cancer Res Treat. 2002;75(1):51-64. https://doi.org/10.1023/A:1016591121762

Lee MJ, Beith J, Ward L, Kilbreath S. Lymphedema following taxane-based chemotherapy in women with early breast cancer. Lymphat Res Biol. 2014;12(4):282-8. https://doi.org/10.1089/lrb.2014.0030

Saibil S, Fitzgerald B, Freedman OC, Amir E, Napolskikh J, Salvo N, et al. Incidence of taxane-induced pain and distress in patients receiving chemotherapy for early-stage breast cancer: a retrospective, outcomes-based survey. Curr Oncol 2010;17(4):42-7. https://doi.org/10.3747/co.v17i4.562

Vega MCMD, Laviano A, Pimentel GD. Sarcopenia e toxicidade mediada pela quimioterapia. Einstein (São Paulo). 2016;14:580-4. https://doi.org/10.1590/s1679-45082016md3740

Rodrigues TCR. Proposta de uma ficha de avaliação fisioterapêutica para pacientes mastectomizadas [Specialization Monograph]. Uberlância, MG: Universidade Federal de Uberlância; 2019 [cited 2022 Jun 1]. 49 p. Available from: https://repositorio.ufu.br/handle/123456789/24650