The sequelae of mastectomy and quadrantectomy with respect to the reaching movement in breast cancer survivors: evidence for an integrated rehabilitation protocol during oncological care.

Autor: Paolucci T; Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy., Bernetti A; Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy., Bai AV; Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy., Segatori L; Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy., Monti M; Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy., Maggi G; University Hospital Umberto I of Rome, Rome, Italy., Ippolitoni G; University Hospital Umberto I of Rome, Rome, Italy., Tinelli L; University Hospital Umberto I of Rome, Rome, Italy., Santilli V; Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy., Paoloni M; Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy., Agostini F; Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy. francescoagostini.ff@gmail.com., Mangone M; Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2021 Feb; Vol. 29 (2), pp. 899-908. Date of Electronic Publication: 2020 Jun 11.
DOI: 10.1007/s00520-020-05567-x
Abstrakt: Background: Breast cancer (BC) is the most common cancer among women in developed countries. Several types of surgical interventions are commonly used in BC, such as mastectomy and quadrantectomy, followed by radiation or not. Today, BC rehabilitation can help survivors obtain and maintain the highest physical, social, psychological, and vocational functioning possible, within the limits that are created by cancer and its treatments.
Objective: To verify, before and after a specific rehabilitation protocol treatment, the recovery of the fluidity of the reaching movement.
Methods: Patients after BC surgery were enrolled and assigned by cluster randomization into 2 groups through a block randomization list: mastectomy (Mas) and quadrantectomy (Quad). Evaluation scales (DASH and VAS) were administered, and biomechanical evaluations were performed for each group before treatment (T0 = baseline), at the end of the rehabilitative treatment (T1 = 12 sessions, 2/week), and after 3 months of follow-up (T2).
Results: Fifty-nine (Mas group = 29; Quad group = 30) after BC surgery were enrolled. VAS scores improved along the evaluation times at T0-T1 and T0-T2 (p < 0.001), without a statistically significant difference between groups. With regard to the normalized jerk, there was no significant interaction between time group (F = 2.029; p = 0.136). There was a significant decrease between T0-T1 and T1-T2 (F = 60.189; p < 0.001). Velocity improved significantly between T0-T1 and T1-T2 (F = 10.322; p < 0.001). There was a significant interaction for the elbow angle at the end of movement between time and group at T2 (F = 5.022; p = 0.029).
Conclusion: The integrated, low-intensity, rehabilitative intervention is effective, even if it is not performed in the first period after BC surgery, without any difference between mastectomy and quadrantectomy.
Databáze: MEDLINE
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