scholarly journals EVALUATING THE RESPONSIVENESS OF THE FULLERTON ADVANCED BALANCE SCALE IN PATIENTS WITH LYMPHEDEMA SECONDARY TO BREAST CANCER SURGERY

Lymphology ◽  
2019 ◽  
Vol 52 (2) ◽  
Author(s):  
AK Yoosefinejad ◽  
M Hadadi ◽  
P Eslamloo
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Treatment Method ◽  
Breast Cancer Treatment ◽  
Breast Cancer Surgery ◽  
Minimal Detectable Change ◽  
Timed Up And Go ◽  
Secondary Lymphedema ◽  
Before And After ◽  
Volumetric Measurements

Lymphedema following surgical treatment for breast cancer can impair balance and predispose patients to falling. Fullerton Advanced Balance (FAB) Scale is a reliable and valid tool which can identify persons with different balance levels, but its responsiveness has not been investigated in patients with lymphedema secondary to breast surgery. Thirty women with stage 2 lymphedema secondary to breast cancer treatment received complex decongestive therapy (CDT) for 2 weeks as a routine treatment method. They were evaluated with FAB Scale and Timed Up and Go Test (TUGT), volumetric measurements and circumferential measurements of the upper limbs before and after CDT. A moderate change was found in FAB score after CDT (Cohen's effect size = 0.65). For FAB, the computed standard error of the mean was 0.85 and minimal detectable change was 2.33. Significant improvement in FAB score and TUGT results, and significant reductions in circumferential and volumetric measurements were seen after 2 weeks of CDT. The FAB score change showed a moderate correlation with circumference change and volumetric change (r = -0.41) but a very weak correlation with TUGT change (r = -0.1). The FAB Scale showed acceptable responsiveness in detecting treatment effects in patients with unilateral secondary lymphedema after breast cancer treatment.

Lymphedema of breast cancer: risk factor and treatment

2015 ◽  
Vol 3 (4) ◽  
pp. 306-321
Author(s):  
Ana H. Losken ◽  
Elisa Mullan
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Cancer Treatment ◽  
Breast Cancer Risk Factor ◽  
Breast Cancer Treatment ◽  
Breast Cancer Surgery ◽  
Secondary Lymphedema ◽  
Lymph Node Transfer ◽  
Arm Lymphoedema ◽  
Chronic Lymphedema

One of the well-known complication of breast cancer treatment is secondary lymphedema; an accumulation of protein-rich interstitial fluid due to the insufficient capacity of the lymphatic system. Lymphedema are affects about 20-30% of women following breast cancer treatment and the risk factors associated with lymphedema development after breast cancer surgery and or radiotherapy are not well established. Early diagnosis and treatment is considered important for successful management of breast cancer related arm lymphoedema. The objective of this study is to assess the value of risk factor and treatment modality of lymphedema. Electronic searches were conducted in MEDLINE®, EMBASE, CINAHL®, and Social Sciences Citation Index. Articles were included where researchers used qualitative research methods and when a comprehensive description of methods and the study's findings were provided. Among 1210 articles, 30-37% developed lymphedema and 45% associated with incresead body mass index (BMI), 53% related with higher stage of disease. Furthermore; 74% strongly step rise with the number of involved lymph nodes; 41% in comorbid diseases, and the time after surgery showed significant correlation with the development of lymphedema in 32%. Suction-assisted protein lipectomy (SAPL) has been shown to safely and effectively reduce the solid component of swelling in chronic lymphedema and microsurgery procedures, including lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), have been shown to be effective in the management of the fluid component of lymphedema and allow for decreased garment use.

scholarly journals Upper extremity bioimpedance before and after treadmill testing in women post breast cancer treatment

2014 ◽  
Vol 148 (2) ◽  
pp. 445-453 ◽  
Author(s):  
Betty Smoot ◽  
Sarah Zerzan ◽  
Joanne Krasnoff ◽  
Josephine Wong ◽  
Maria Cho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Upper Extremity ◽  
Breast Cancer Treatment ◽  
Treadmill Testing ◽  
Before And After

scholarly journals Role of physiotherapy in supporting recovery from breast cancer treatment: a qualitative study embedded within the UK PROSPER trial

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e040116
Author(s):  
Sophie Rees ◽  
Bruno Mazuquin ◽  
Helen Richmond ◽  
Esther Williamson ◽  
Julie Bruce
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Exercise Intervention ◽  
Well Being ◽  
Breast Cancer Treatment ◽  
Breast Cancer Surgery ◽  
Sense Of Control ◽  
Post Surgery ◽  
The Uk ◽  
Behavioural Strategies

ObjectivesTo explore the experiences of women with breast cancer taking part in an early physiotherapy-led exercise intervention compared with the experiences of those receiving usual care. To understand physiotherapists’ experience of delivering the trial intervention. To explore acceptability of the intervention and issues related to the implementation of the Prevention Of Shoulder Problems (PROSPER) programme from participant and physiotherapist perspective.DesignQualitative semistructured interviews with thematic analysis.SettingUK National Health Service.ParticipantsTwenty participants at high risk of shoulder problems after breast cancer surgery recruited to the UK PROSPER trial (10 each from the intervention arm and control arm), and 11 physiotherapists who delivered the intervention. Trial participants were sampled using convenience sampling. Physiotherapists were purposively sampled from high and low recruiting sites.ResultsParticipants described that the PROSPER exercise intervention helped them feel confident in what their body could do and helped them regain a sense of control in the context of cancer treatment, which was largely disempowering. Control arm participants expressed less of a sense of control over their well-being. Physiotherapists found the exercise intervention enjoyable to deliver and felt it was valuable to their patients. The extra time allocated for appointments during intervention delivery made physiotherapists feel they were providing optimal care, being the ‘perfect physio’. Lessons were learnt about the implementation of a complex exercise intervention for women with breast cancer, and the issues raised will inform the development of a future implementation strategy.ConclusionsA physiotherapist-delivered early supported exercise intervention with integrated behavioural strategies helped women at risk of shoulder problems following breast cancer treatment to feel more confident in their ability to mobilise their arm post-surgery. A physiotherapist-delivered early supported exercise intervention with integrated behavioural strategies may address the sense of powerlessness that many women experience during breast cancer treatment.Trial registration numberISRCTN35358984.

scholarly journals Lymphatic Venous Anastomosis Can Release the Lymphedema-Associated Pain of Upper Limb after Breast Cancer Treatment

2018 ◽  
Vol 03 (01) ◽  
pp. e1-e7 ◽  
Author(s):  
Makoto Mihara ◽  
Hisako Hara ◽  
Han Zhou ◽  
Shuichi Tange ◽  
Kazuki Kikuchi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Cancer Treatment ◽  
Upper Limb ◽  
Pain Scale ◽  
Breast Cancer Treatment ◽  
Venous Anastomosis ◽  
Before And After ◽  
Vas Scores

Background Sometimes, chronic pain in the arm or chest could occur in postmastectomy patients. Although the pathology of the pain is unclear, the involvement of neurological mechanism, cicatricial contracture, or lymphedema is considered. The purpose of this study was to investigate the effectiveness of lymphaticovenous anastomosis (LVA) in reducing chronic pain in upper limb lymphedema patients. Patients and Methods This prospective study included consecutive 13 patients with upper limb lymphedema who received LVA. Preoperative lymphoscintigraphy and indocyanine green lymphography were performed. Pre- and postoperative pain scale were recorded using the visual analog scale (VAS). The number of cellulitis 1 year before and after LVA were compared. LVA was performed under local anesthesia, using a surgical microscope, and 12–0 nylon suture was used in the anastomosis. Results Two out of 13 patients were excluded from this study, and 11 patients were subjected to this study. All subjects were females with an average age of 64.3 years. The average lymphedema duration was 76.7 months. The average number of LVA sites was 5.7 per limb and the average follow-up period was 10.6 months. The average pre- and postoperative VAS scores were 3.5 and 0.59, respectively; the significant decrease was observed (p = 0.017). Three of the patients who had experienced cellulitis (once, twice, and four times, respectively) did not develop any cellulitis after LVA. Conclusion LVA was shown to be an effective surgical remedy for treating the lymphedema-associated pain of upper limb after breast cancer treatment.

scholarly journals Caution Ahead: Research Challenges of a Randomized Controlled Trial Implemented to Improve Breast Cancer Treatment at Safety-Net Hospitals

2018 ◽  
Vol 14 (3) ◽  
pp. e158-e167
Author(s):  
Nina A. Bickell ◽  
Ajay Shah ◽  
Maria Castaldi ◽  
Theophilus Lewis ◽  
Alan Sickles ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Implementation Research ◽  
Care Delivery ◽  
Safety Net ◽  
Breast Cancer Treatment ◽  
Breast Cancer Surgery ◽  
Key Informants ◽  
High Volume Hospital

Purpose: To implement and test a Web-based tracking and feedback (T&F) tool to close referral loops and reduce adjuvant breast cancer treatment underuse in safety-net hospitals (SNHs). Patient and Methods: We randomly assigned 10 SNHs, identified patients with new stage 1 to stage 3 breast cancer, assessed their connection with the oncologist, and relayed this information to surgeons for follow-up. We interviewed key informants about the tool’s usefulness. We conducted intention-to-treat and pre- and poststudy analyses to assess the T&F tool and implementation effectiveness, respectively. Results: Between the study start and intervention implementation, several hospitals reorganized care delivery and 49% of patients scheduled to undergo breast cancer surgery were ineligible because they already were in contact with an oncologist. One high-volume hospital closed. Despite randomization of hospitals, intervention (INT) hospitals had fewer white patients (5% v 16%; P = .0005), and more underuse (28% v 15%; P = .002) compared with usual care (UC) hospitals. Over time, INT hospitals with poorer follow-up significantly reduced underuse compared with UC hospitals (INT hospitals, from 33% to 9%, P = .001 v UC hospitals, from 15% to 11%, P = .5). There was no difference in underuse (9% at INT hospitals, 11% at UC hospitals; P = .8). Hospitals with better follow-up (odds ratio, 0.85; 95% CI, 0.73 to 0.98) had less underuse. In settings with poor follow-up and tracking approaches, key informants found the tool useful. The rapidly changing delivery landscape posed significant challenges to this implementation research. Conclusion: A T&F tool did not significantly reduce adjuvant underuse but may help reduce underuse in SNHs with poor follow-up capabilities. Inability to discern T&F effectiveness is likely due to encountered challenges that inform lessons for future implementation research.

scholarly journals Connexin 47 Mutations Increase Risk for Secondary Lymphedema Following Breast Cancer Treatment

2012 ◽  
Vol 18 (8) ◽  
pp. 2382-2390 ◽  
Author(s):  
David N. Finegold ◽  
Catherine J. Baty ◽  
Kelly Z. Knickelbein ◽  
Shelley Perschke ◽  
Sarah E. Noon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Secondary Lymphedema ◽  
Increase Risk

Physiotherapy in women after breast cancer treatment – review

2019 ◽  
Vol 1 ◽  
pp. 162-168
Author(s):  
K. Skutnik ◽  
W. Ustymowicz ◽  
K. Zubrewicz ◽  
J. Zińczuk ◽  
D. Kamińska ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Upper Limb ◽  
Pain Syndrome ◽  
Rehabilitation Program ◽  
Breast Cancer Treatment ◽  
Pulmonary Complications ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breathing Exercises

<br/><b>Introduction:</b> Breast cancer is the most common malignant tumor in women in the Polish region. Surgery is a basic method of breast cancer treatment. Surgery often carries a lot of unwanted changes as follows: limitation of mobility in the shoulder joint on the operated side, secondary lymphoedema, post mastectomy pain syndrome (PMPS), reduction of muscle strength or disorders in body posture. Therefore, the implementation of physiotherapeutic activities that are designed to prevent and eliminate postoperative complications seems very important. The main aim of this work was to present physiotherapeutic management in women after mastectomy based on the analysis of available literature. The physiotherapeutic process can be divided into three periods: early hospital, early ambulatory and the late ambulatory period. In the first period, active slow exercises, self-support of the upper limb on the operated side and breathing exercises on the thoracic track are used to prevent circulatory disorders, pulmonary complications, and edema. The early ambulatory period includes corrective exercises, general improvement exercises, stretching and learning of automatic massage of the upper limb of the operated side. The last period should be enriched by recreational methods of physical activity such as swimming, cycling or Nordic walking to maintain physical fitness, proper mobility of the shoulder girdle and improve the patient's psychophysical state. It is very important the patient regular continues the rehabilitation program after curing of breast cancer as well. In the case of secondary lymphoedema of the upper limb, comprehensive rehabilitation physiotherapy is used, consisting of manual lymphatic drainage, healing exercises, compression therapy, and skin care. <br/><b>Conclusions:</b> Physiotherapy in women after breast cancer surgery is a complex and long-term process. Physiotherapeutic methods are effective in treating complications after surgery of breast cancer surgery. It is necessary to constantly update the physio-therapy knowledge in women after breast cancer surgery.

scholarly journals Randomised controlled trial of exercise to prevent shoulder problems in women undergoing breast cancer treatment: study protocol for the prevention of shoulder problems trial (UK PROSPER)

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019078 ◽  
Author(s):  
Julie Bruce ◽  
Esther Williamson ◽  
Clare Lait ◽  
Helen Richmond ◽  
Lauren Betteley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
High Risk ◽  
Randomised Controlled Trial ◽  
Cancer Treatment ◽  
Usual Care ◽  
Controlled Trial ◽  
Breast Cancer Treatment ◽  
Breast Cancer Surgery ◽  
Randomised Controlled

Musculoskeletal shoulder problems are common after breast cancer treatment. Early postoperative exercises targeting the upper limb may improve shoulder function. This protocol describes a National Institute for Health Research-funded randomised controlled trial (RCT) to evaluate the clinical and cost-effectiveness of an early supervised structured exercise programme compared with usual care, for women at high risk of developing shoulder problems after breast cancer surgery.MethodsThis pragmatic two-armed, multicentre RCT is underway within secondary care in the UK. PRevention Of Shoulder ProblEms tRial (PROSPER) aims to recruit 350 women from approximately 15 UK centres with follow-up at 6 weeks, 6 and 12 months after randomisation. Recruitment processes and intervention development were optimised through qualitative research during a 6-month internal pilot phase. Participants are randomised to the PROSPER intervention or best practice usual care only. The PROSPER intervention is delivered by physiotherapists and incorporates three main components: shoulder-specific exercises targeting range of movement and strength; general physical activity and behavioural strategies to encourage adherence and support exercise behaviour. The primary outcome is upper arm function assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at 12 months postrandomisation. Secondary outcomes include DASH subscales, acute and chronic pain, complications, health-related quality of life and healthcare resource use. We will interview a subsample of 20 participants to explore their experiences of the trial interventions.DiscussionThe PROSPER study is the first multicentre UK clinical trial to investigate the clinical and cost-effectiveness of supported exercise in the prevention of shoulder problems in high-risk women undergoing breast cancer surgery. The findings will inform future clinical practice and provide valuable insight into the role of physiotherapy-supported exercise in breast cancer rehabilitation.Protocol versionVersion 2.1; dated 11 January 2017Trial registration numberISRCTN35358984; Pre-results.

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