Winged scapula incidence was 8.0 % and was higher in AL, and prevalence decreased during 6 months after surgery. Patients who developed winged scapula had more shoulder flexion, adduction, and abduction limitation.

There was no difference between groups. Both groups showed statistically significant improvement of the items assessed: pain, depression, upper limb function, and ADM, and there was no difference between them.

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Objective: The objective is to evaluate the effect of limiting shoulder range of motion (ROM) for 15 or 30 days on surgical complications and on shoulder ROM, pain, and upper limb function of breast cancer patients following conservative oncoplastic surgery.Materials and Methods: A randomized clinical trial was conducted with 60 women with breast cancer who underwent conservative oncoplastic surgery. The day after surgery, all patients started an exercise protocol with shoulder exercises limited to 90 degrees. Two weeks after surgery they were randomized into Free ROM Group (n = 30) or Limited ROM Group (n = 30). The Free ROM Group was allowed to perform shoulder exercises with unlimited ROM; the Limited ROM Group continued with shoulder movement restricted at 90 degrees until 30 days after surgery, at which time they were also allowed free ROM. The primary outcome was the incidence of postoperative complications (dehiscence, seroma, infection, and necrosis) and secondary outcomes were shoulder ROM, pain, and upper limb function.Results: No difference in the incidence of postoperative scar complications between groups was noted. There was no difference between the groups in shoulder joint amplitude, pain, or upper limb function. Conclusions:The free ROM exercise protocol 15 days post surgery was safe concerning cicatricial complications.

SUMMARY Breast cancer is one of the most common types of tumor in the world and the most common among women. There are several treatments for breast cancer; however, the condition often can be accompanied by severe complications in a woman's life. OBJECTIVE: o evaluate and compare body image perception, quality of life, tenderness, and pain in women with breast cancer during preoperative and postoperative periods of 30, 60 and 90 days. MATERIALS AND METHODS: We conducted a prospective longitudinal study. The patients answered the questionnaire “How I relate to my own body”, EORTC QLQ-C30 and EORTC QLQ-BR23. We assessed upper limb and breast sensitivity with an esthesiometer. Patients were questioned about the presence and level of pain on a scale of 0 to 10. RESULTS: For body image, it was possible to observe a significant difference between pre and postoperative at 30 days. There were changes in some areas of the EORTC QLQ C30 and EORTC QLQ BR23 questionnaires, such as arm and breast symptoms, social function, constipation, sexual function and satisfaction, among others. For evaluation of breast and axilla sensitivity and assessment of pain, all postoperative periods showed significant differences when compared to the preoperative period. The sensitivity of the inner region of the arm presented no significant change. CONCLUSION: The difference found in the study shows that evaluations on all scales should be done in several periods, using a proper treatment for the changes and individuality of each patient.

Objective: The aim of this study was to compare three distinct rehabilitation treatments (exercise therapy, acupuncture, and Stiper®) in women undergoing breast cancer surgery, assessing strength, lymphedema, and quality of life. Methods: In all, 79 women with pain above 3 on the visual analog pain scale (VAS) and with more than 90 days of surgery were included. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, predefined exercise therapy, based on stretching of the cervical muscles, shoulder girdle, and shoulder ROM exercises with a duration of 30 min; group II (G2) treated with 30 min of acupuncture using predefined points; and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper® (silicon oxide micronized quartz pellet) in place of needles. Results: A total of 67 patients completed the treatment – 26 from G1, 23 from G2, and 18 from G3. There was an improvement in upper limb muscle strength over time in all groups, except for abduction and internal rotation movements. During treatment, there was no increase in the number of patients with lymphedema, and there was no statistical difference between the groups. Regarding the EORTC QLQ-C30 quality of life questionnaire, 9 of the 15 factors analyzed showed significant differences between sessions. The factors that did not have significant differences between the three groups were social function, nausea and vomiting, dyspnea, loss of appetite, constipation, and diarrhea. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture, and Stiper® in upper limb muscle strength, lymphedema, and quality of life proved to be effective without superiority between groups, which leads to the conclusion that acupuncture showed equivalence of results when compared with exercise therapy, thus being an effective approach for the rehabilitation of these women.

Introduction: The continuous advancement in the early detection and treatment of breast cancer has significantly reduced mortality and, consequently, increased the number of survivors with treatment side effects that affect the quality of life, such as lymphedema, loss of upper limb strength, shoulder dysfunction, decreased functional capacity, flexibility, and joint mobility. Exercise therapy is a recognized practice for the rehabilitation of these disorders; however, acupuncture needs to be better evaluated to compare its equivalence with classical therapy. Objective: The aim of this study was to compare three distinct rehabilitation treatments (exercise therapy, acupuncture, and Stiper®) in women undergoing breast cancer surgery, assessing strength, lymphedema, and quality of life. Methods: In total, 79 women with pain above 3 on the visual analog scale (VAS) and with more than 90 days of surgery were included. The research was approved by the Research Ethics Committee (CEP) of the Universidade Federal de São Paulo/Hospital São Paulo on May 13, 2016, under number 1.543.582 and registered in the Clinical Trials Registry on January 11, 2016, with number NCT02798263. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, predefined exercise therapy, based on stretching of the cervical muscles, shoulder girdle, and shoulder ROM exercises with a duration of 30 min; group II (G2) treated with 30 min of acupuncture using predefined points; and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper® (silicon oxide micronized quartz pellet) in place of needles. Results: In all, 67 patients completed the treatment, being 26 from G1, 23 from G2, and 18 from G3. There was an improvement in upper limb muscle strength over time in all groups, except for abduction and internal rotation movements. During treatment, there was no increase in the number of patients with lymphedema and there was no statistical difference between the groups. Regarding the EORTC QLQ-C30 quality-of-life questionnaire, 9 of the 15 factors analyzed showed significant differences between sessions. The factors that did not have significant differences between the three groups were social function, nausea and vomiting, dyspnea, loss of appetite, constipation, and diarrhea. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture, and Stiper® in upper limb muscle strength, lymphedema, and quality of life proved to be effective, without superiority between groups. Thus, acupuncture showed equivalence of results when compared with exercise therapy, thus being an effective approach for the rehabilitation of these women.

Introduction: The treatment of breast cancer can trigger physical dysfunctions and psychological difficulties such as pain, depression, limitation of upper limb function, and shoulder range of motion (ROM) deficits. Exercise therapy is a treatment well established in the literature for these disorders and acupuncture is an alternative to it. However, most studies using acupuncture only assess pain. Objective: The aim of this study was to compare three distinct rehabilitation treatments (exercise therapy, acupuncture, and Stiper®) in women undergoing breast cancer surgery, assessing pain, depression, upper limb function, and ROM parameters. Methods: In total, 79 women with pain above 3 on the visual analog scale (VAS) and with more than 90 days of surgery were included. The research was approved by the Research Ethics Committee (CEP) of the Universidade Federal de São Paulo/Hospital São Paulo on May 13, 2016, under number 1.543.582, and registered in the Clinical Trials Registry on January 11, 2016, with number NCT02798263. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, predefined exercise therapy, based on stretching of the cervical muscles, shoulder girdle, and shoulder ROM exercises with a duration of 30 min; group II (G2) treated with 30 min of acupuncture using predefined points; and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper ® (silicon oxide micronized quartz pellet) in place of needles. Results: In all, 67 patients completed the treatment, being 26 from G1, 23 from G2, and 18 from G3. There was a decrease in pain over time in all groups (first session compared with the fifth (p <0.001) and with the tenth (p<0.001), but not between groups. There was a statistically significant difference in depressive symptoms using the Beck questionnaire over time in the three groups (between the first and tenth sessions [p=0.001], between the first and fifth sessions [p=0.052], but not between groups). Regarding the DASH questionnaire for shoulder function, there were significant differences over time at all evaluated moments (p <0.001), but not between groups. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture, and Stiper® proved to be effective, without superiority between the groups. We conclude that acupuncture showed equivalent results when compared with exercise therapy, thus being an effective approach in the rehabilitation of these women.