One hundred seventy-four women were examined. The mean age was 58 years. The incidence of pain syndrome was 52%. Younger women (<40 years) and those who were submitted to axillary lymph node dissection (with more than 15 lymph nodes excised) have shown a significantly increased risk of pain syndrome after surgery for breast cancer (relative risk (RR) =5.23 95% confidence interval (CI): 1.11-24.64) and (RR=2.01 95% CI: 1.08-3.75).
The objective of the study is to estimate the incidence and risk factors of axillary web syndrome (AWS) in early postoperative period (45 days). From the prospective cohort of women undergoing breast cancer surgery, we collected the variables related to patient characteristics, treatment, tumor, and postoperative complications. We performed bivariate and logistic regression. A total of 193 patients are included with a mean age of 58.26 years, majority of which are women who are overweight or obese (72.3%). The incidence of AWS was 28.1%. The presence of pain in the ipsilateral upper-limb associated with AWS was reported in 5.4% of the patients, and the shoulder joint restriction was observed in 11.4%. When controlling for confounding between AWS and the factors that showed statistical significance in bivariate analysis, the variables that explain the occurrence of the AWS were the type of axillary surgery, where women who underwent sentinel lymph node biopsy showed 68% less risk compared with those that underwent axillary lymphadenectomy (AL) (RR = 0.32; 95% CI, 0.13-0.79; P value = 0.014) and numbness in the arm after an injury of the intercostobrachial nerve, which is 3.19 times the risk of the AWS (RR = 3.19; 95% CI, 1.40-7.29, P value = 0.006). From the above findings, we concluded that the incidence of AWS was 28.1%, and it was associated with AL and numbness in the arm after injury of the intercostobrachial nerve.
Purpose. To assess the quality of life (QOL) as a predictor of volume reduction in women undergoing complex physical therapy (CPT) for lymphoedema following breast cancer. Methods. Clinical trial in 57 women undergoing CPT. Results. At baseline, in measuring quality of life for the EORTC QLQ-C30 questionnaire subscale of functionality, the worst scores for emotional function (55 points) and better social function (89 points) were observed. The symptom scales showed the worst pain averaged (66 points). The overall quality of life showed a low score (40 points). In the BR 23 module, low scores were observed in the field of future perspective (47 points). After treatment of lymphoedema, absolute reduction of excess volume between the upper limbs of 282 mL was observed, representing a reduction of 15%. No association was observed between the domains of quality of life and response to treatment of lymphoedema. Conclusion. This study included 57 women with advanced and chronic lymphoedema in early treatment with CPT and low scores for quality of life. The lymphoedema therapeutic response was not influenced by the QOL at the beginning of treatment.
Introdução: Em decorrência do tratamento do câncer de mama, as mulheres podem evoluir com alterações funcionais, sociais e psicológicas que podem levar a perda de papéis relacionados ao trabalho, família e sexualidade. Objetivo: Avaliar a funcionalidade do membro superior das mulheres submetidas à cirurgia para tratamento do câncer de mama, acompanhadas pelo serviço de fisioterapia em uma instituição pública de referência do Sistema Único de Saúde no Estado do Rio de Janeiro. Método: Estudo transversal em mulheres submetidas a tratamento cirúrgico para câncer de mama. Variáveis relacionadas as características da mulher, do tratamento, do tumor e da funcionalidade do membro superior, mensurada por meio do questionário Disability Arm Shoulder and Hand foram coletadas. Foi realizada uma análise descritiva das variáveis do estudo por meio de medidas de tendência central e de dispersão para as variáveis contínuas e frequências relativa e absoluta para as variáveis categóricas. Resultados: Foram incluídas 105 mulheres que apresentavam idade média de 55,82 anos e índice de massa corporal de 27,80. A inclusão no estudo, a média de tempo transcorrido da cirurgia foi de 1,85 ano. A média do escore total da funcionalidade foi de 27,07 (DP=16,54). Conclusão: Observou-se um escore satisfatório de capacidade funcional e execução das atividades da vida diária normalmente, contrapondo os estudos realizados por outros autores. Esse resultado positivo deve-se, possivelmente, a atuação da fisioterapia precocemente no tratamento dessas pacientes, comprovando a real necessidade da intervenção fisioterapêutica.
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