Abstract

Appropriate and timely rehabilitation is vital in the recovery from breast cancer surgeries, including breast conserving surgery, mastectomy, axillary lymph node dissection (ALND), and breast reconstruction. This article describes the incidence, prevalence, risk factors and time course for early postoperative effects and the role of prospective surveillance as a rehabilitation strategy to prevent and mitigate them. The most common early postoperative effects include wound issues such as cellulitis, flap necrosis, abscess, dehiscence, hematoma, and seroma. Appropriate treatment is necessary to avoid delay in wound healing that may increase the risk of long-term morbidity, unduly postpone systemic and radiation therapy, and delay rehabilitation. The presence of upper quarter dysfunction (UQD), defined as restricted upper quarter mobility, pain, lymphedema, and impaired sensation and strength, has been reported in over half of survivors after treatment for breast cancer. Moreover, evidence suggests that survivors who undergo breast reconstruction may be at higher risk of UQD. Ensuring the survivor's optimum functioning in the early postoperative time period is critical in the overall recovery from breast cancer. The formal collection of objective measures along with patient-reported outcome measures is recommended for the early detection of postoperative morbidity. Prospective surveillance, including preoperative assessment and structured surveillance, allows for early identification and timely rehabilitation. Early evidence supports a prospective approach to address and minimize postoperative effects.

Links

Publisher Full Text

Authors

McNeely ML, Binkley JM, Pusic AL, Campbell KL, Gabram S, Soballe PW

Institution

Department of Physical Therapy and Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada. mmcneely@ualberta.ca

Source

Cancer 118:8 Suppl 2012 Apr 15 pg 2226-36

MeSH

Adult
Age Factors
Aged
American Cancer Society
Breast Neoplasms
Congresses as Topic
Exercise
Female
Follow-Up Studies
Humans
Longitudinal Studies
Lymphedema
Mammaplasty
Mastectomy
Middle Aged
Pain, Postoperative
Physical Therapy Modalities
Postoperative Care
Postoperative Complications
Prospective Studies
Quality of Life
Recovery of Function
Risk Assessment
Survival Rate
Time Factors
Treatment Outcome
United States

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22488697