肿瘤外科档案

Rehabilitation of patients after breast cancer surgery

Abstract

Dr. Ana Golez

Incidence of breast cancer ranges from 89.7 per 100,000 women in Western Europe, about 40 per 100,000 in developing countries and to 19.3 per 100,000 women in Eastern Africa (1). The 5-year relative survival rate for breast cancer in the US was 91% from 2009-2015 (2). Treatment of breast cancer typically requires a potent combination of surgery, radiation and chemotherapy, and in a hormonal type of breast cancer also a hormonal therapy (3). Rehabilitation of patients after breast cancer surgery is important and its aim is to return to all presurgery activities of daily living with no pain (3,4). Rehabilitation should be induvidually Physical therapy is helpful in reducing swelling, improving range of motion and strength, increasing energy and returning to presurgery lifestyle (3,4) After a mastectomy, double mastectomy or lymphadenectomy woman are expected to rest and limit arm movements in the first week or more after surgery (3). In case of lymphedema lympdrainage and compression orthosis can be helpful (4). Later gentle exercises can be started, deep breathing and walking short distances (3,4). Being more active helps with prognosis (3,4). Studies show that patients after breast cancer surgery have considerable impairments in cardiorespiratory fitness, because of the toxic effects of anticancer therapy and deconditioning (3,4). This can lead to functional dependence, cardiovascular morbidity and mortality (3,4). On the other side women, who exercise for three to five hours per week (e.g walking on a treadmill) improved their survival rate as much as 40 percent over less active breast cancer patients (4). Induvidualized rehabilitation of patients after breast cancer surgery is important and can help in returning to all presurgery activities of daily living with no pain