ABSTRACT
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.
ABSTRACT
Introdução: Em decorrência do tratamento do câncer de mama, as mulheres podem evoluir com alterações funcionais, sociais e psicológicas que podem levar à 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 às características da mulher, do tratamento, do tumor e da funcionalidade do membrosuperior, 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. À 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 diárianormalmente, contrapondo os estudos realizados por outros autores. Esse resultado positivo deve-se, possivelmente, à atuação da fisioterapia precocemente no tratamento dessas pacientes, comprovando a real necessidade da intervençãofisioterapêutica
Introduction:as a result of the breast cancer treatment, women can develop functional, social and psychological alterations that can lead to loss of roles related to work, family and sexuality. Objective: to evaluate the functionality of the upper limb of women undergoing surgery for breast cancer, followed by a physiotherapy service in a public unitwhich is a reference in the unified Healt hsystem in the state of rio de Janeiro...
Subject(s)
Humans , Female , Cross-Sectional Studies , Breast Neoplasms/surgery , Physical Therapy Modalities , Rehabilitation , Upper ExtremityABSTRACT
INTRODUCTION: Advanced breast cancer is a very frequent serious public health problem. OBJECTIVE: This study aimed to analyze the prevalence of arm symptoms and overall survival in affected patients. METHODOLOGY: A retrospective cohort study was accomplished in 196 women presenting with advanced breast cancer. A descriptive analysis was carried out by and overall survival probabilities were calculated according to Kaplan-Meier method and Cox regression. RESULTS: These included 196 woman had a medium age of 55.9 years, the majority being obese (71.3%) and having a IIIB clinical staging (52.3%). The most prevalent arm symptoms were pain (54.6%), paresthesia in upper limb (8.5%), lymphedema (> 200 ml) (6.6%), shoulder restriction (4.7%) and axillary web syndrome (0.6%). The median follow-up was 18.7 months (SD 7,33), 4.0% of the patients had metastasis and 31.6% were dead. The mean free disease survival was 20.4 months (95% CI 18.4-22.4), and the mean survival time was 26.3 months (95% CI 24.7-28.0). After adjusted the association with arm symptom and overall survival for clinical stage and presence of distant metastasis, the shoulder restriction was a predict variable, were represents the risk 2.59 for worse survival in compared with woman with no shoulder restriction (CI 95% 1.06-5.98). CONCLUSION: The population studied at this study presented high prevalence of complications earlier than neo adjuvant treatment. After controlling for effects of tumor variables, the shoulder restriction was statistically associated with poor overall survival after 2 years.
