ABSTRACT
BACKGROUND: Sentinel lymph node biopsy (SLNB) is commonly used for the treatment of breast cancer with minimal surgical intervention as well as with low morbidity rates of upper limbs. OBJECTIVES: The aim of the present study was to investigate possible impairments and functional performance of the upper limb on activities of daily living (ADL) and health related quality of life (HRQL) among women treated through SLNB in a Brazilian hospital and to study the association among these variables. METHODS: Forty-five women (58.9±9.3 years) participated in this descriptive, cross-sectional and correlational study. The visual analogue scale (VAS) was used to quantify pain intensity/discomfort, arm circumference and shoulder range of motion (ROM) measurement were used to measure upper limb impairments. The Disabilites of Arm Shoulder and Hand questionnaire (DASH) was used to quantify functional performance of upper limb during ADL and European Organisation for Research and Treatment of Cancer - Quality of Life Questionnaire - Cancer 30 (EORTC-QLQ-C30) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Breast Cancer Module 23 (EORTC-BR23) were used to characterize HRQL. RESULTS: Results revealed a 75 percent prevalence of symptoms affecting upper limb (pain or discomfort in arm, shoulder) or breast, although the severity of the symptoms was only mild. Only 4.4 percent exhibited lymphedema and no ROM restriction was observed. There was little limitation in functional performance of the upper limb, which was associated with Arm Symptoms scale (EORTC BR-23). Impairments and functional performance of upper limb did not interfere on HRQL perception, which was considered to be good. CONCLUSION: SLNB caused small impairments and limitation on the functional performance of the upper limb during ADL and did not influence HRQL in our sample.
CONTEXTUALIZAÇÃO: A biópsia de linfonodo sentinela (BLS) é um procedimento cirúrgico minimamente invasivo para o tratamento do câncer de mama, o qual pode reduzir a morbidade de membros superiores (MMSS). OBJETIVOS: Investigar as possíveis deficiências e o desempenho funcional de MMSS em atividades de vida diária (AVDs) e a qualidade de vida relacionada à saúde (QVRS) entre mulheres submetidas à BLS em hospital da região sudeste do Brasil e estudar a associação entre essas variáveis. MÉTODOS: Trata-se de estudo descritivo, transversal e correlacional do qual participaram 45 mulheres (58,9±9,3 anos). A avaliação das disfunções foi realizada por meio da medida da perimetria e da amplitude de movimento (ADM) de ombros, do relato e da quantificação da intensidade da dor/desconforto, utilizando Escala Visual Analógica (EVA). O questionário Disabilites of Arm Shoulder and Hand (DASH) foi utilizado para medir o desempenho funcional de MMSS durante as AVDs. Para avaliar a QVRS, foram utilizados os questionários European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Cancer 30 (EORTC QLQ-C30) e a escala de Sintomas do Braço (SB) do European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Breast Cancer Module 23 (EORTC BR-23). RESULTADOS: Houve alta prevalência (75 por cento) de sintomas que acometem MMSS (dor ou desconforto no braço ou ombro) ou mama. Apesar disso, os sintomas foram de leve intensidade. Apenas 4,4 por cento apresentaram linfedema. Não houve limitação da ADM de ombros, e houve pouca limitação no desempenho funcional de MMSS, o que esteve associado com a escala SB do EORTC BR-23. As disfunções e o desempenho funcional de MMSS não interferiram na percepção sobre a QVRS, que foi considerada boa. CONCLUSÃO: Nesta amostra, observou-se pouca disfunção e limitação do desempenho funcional de MMSS nas AVDs, sem influenciar a QVRS.