The effects of complete decongestive therapy on the extent of secondary lymphoedema in women after breast cancer treatment

Physiotherapy ◽  
2015 ◽  
Vol 23 (1) ◽  
Author(s):  
Iwona Malicka ◽  
Dawid Marciniak
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Post Treatment ◽  
Control Group ◽  
Study Group ◽  
Complete Decongestive Therapy ◽  
The Mean ◽  
Decongestive Therapy

AbstractAim of the study was to assess the effects of Complete Decongestive Therapy (CDT) on the extent of lymphedema of the upper extremity in women post cancer treatment.Study group: 20 women after breast cancer treatment with a mean age of 63.15 years (± 8.15). The group was intentionally divided into 2 groups: patients with lymphedema and patients without lymphedema. The first group (study group, n = 10) consisted of women who received CDT. 70% of them had undergone mastectomy and 30% – breast-conserving surgery. In addition, 60% had received radiotherapy, 70% – chemotherapy and 80% – hormone therapy. The mean post-treatment period was 6.2 ± 3.5 years. Patients in the second group (control group, n = 10) did not receive any anti-edema treatments. 90% of them had undergone mastectomy and 10% – breast-conserving surgery. In addition, 40% of study participants had received adjuvant treatment in the form of radiotherapy, 80% – chemotherapy and 50% – hormone therapy. The mean post-treatment period was 6.3 ± 4.4 years. Method: The extent of lymphedema was measured using a centimeter tape and Limb Volumes Professional 5.0 software.A significant reduction in the extent of lymphedema (p = 0.005) was achieved in the CDT group between baseline and post-treatment assessments. No such reduction, however, was found in the control group (p = 0.33).Complete decongestive therapy is an effective method of treatment of lymphedema in women post breast cancer treatment.

scholarly journals A preliminary study of manipulation under anaesthesia for secondary frozen shoulder following breast cancer treatment

2014 ◽  
Vol 96 (2) ◽  
pp. 111-115 ◽  
Author(s):  
A Leonidou ◽  
DA Woods
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Breast Cancer Treatment ◽  
Control Group ◽  
Study Group ◽  
Breast Cancer Patients ◽  
Manipulation Under Anaesthesia ◽  
Preliminary Study

Introduction The aim of this paper is to present the results of manipulation under anaesthesia (MUA) and injection of local anaesthetic and corticosteroid followed by a physiotherapy regime for secondary frozen shoulder after breast cancer treatment (surgery, radiotherapy), and to compare them with a control group. Methods Patients referred to the senior author for secondary frozen shoulder following breast cancer treatment over a ten-year period were investigated. Recorded data included age, treatment for breast cancer, length of symptoms, Oxford shoulder score (OSS) and range of motion before and after shoulder MUA. These data were compared with a control group of patients with frozen shoulder. Results A total of 263 patients were referred with 281 frozen shoulders. Of these, 7 patients (7 shoulders) had undergone previous breast cancer treatment and the remaining 256 patients (274 shoulders) formed the control group. None of the patients were diabetic. The mean preoperative OSS was 31 for the study group and 27 for the control group, improving to 43 for both groups following MUA. Forty-two per cent of the study group and fifteen per cent of the control group had a second MUA subsequently. At the long-term follow-up appointment, 71% of the study group patients were satisfied with their result. Conclusions The results of this preliminary study suggest that MUA, corticosteroid injection and subsequent physiotherapy have achieved good final results in a series of patients with frozen shoulder secondary to breast cancer treatment. Members of the multidisciplinary team looking after breast cancer patients should be aware of this management option and, on manifestation of this pathology, should refer the patient to an orthopaedic surgeon.

scholarly journals Re-Excision Rates in Breast-Conserving Surgery for Invasive Breast Cancer after Neoadjuvant Chemotherapy with and without the Use of a Radiopaque Tissue Transfer and X-ray System

Breast Care ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 302-307
Author(s):  
Suniza Jamaris ◽  
Leyla Akpolat-Basci ◽  
Miltiades Stephanou ◽  
Sarah Wetzig ◽  
Yueksel Cubuk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Invasive Breast Cancer ◽  
Breast Conserving Surgery ◽  
Control Group ◽  
Study Group ◽  
Transfer System ◽  
Tissue Transfer ◽  
Resected Tissue ◽  
Specimen Radiography

Background: Significant re-excision rates in breast-conserving surgery (BCS) after neoadjuvant systemic chemotherapy may result from difficulties in defining the surgical target particularly in cases with excellent treatment response. Devices allowing an exact topographic localisation of the lesion in the resected tissue could reduce re-excision rates by optimising the intraoperative detection of involved margins. Methods: 80 patients with invasive breast cancer receiving BCS after neoadjuvant chemotherapy were included in this non-randomized case-control study. 40 patients with specimen radiography performed in a standard approach (control group) were compared to 40 patients with use of a radiopaque tissue transfer system (study group). Results: 19/80 (23.75%) patients required re-excision because of involved margins; among those, 14/40 (35%) were in the control group and 5/40 (12.5%) in the study group. The association between the use of the radiopaque tissue transfer system and the lower re-excision rate was statistically significant (p = 0.023). Conclusion: Our analysis provides a rationale for the routine use of a radiopaque tissue transfer system for specimen radiography in BCS after neoadjuvant chemotherapy for invasive breast cancer in order to reduce re-excision rates.

Inpact of a ten week mind-body medicine intervention on peristent fatigue following breast cancer treatment: 6 month follow- up

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9062-9062
Author(s):  
K. J. Helzlsouer ◽  
S. E. Appling ◽  
S. Scarvalone ◽  
M. McBeth ◽  
L. Gallicchio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Cancer Survivors ◽  
Subscale Score ◽  
Breast Cancer Treatment ◽  
Fatigue Score ◽  
Sf 36 ◽  
Persistent Fatigue ◽  
The Mean ◽  
Mind Body Medicine

9062 Background: Persistent fatigue following breast cancer treatment, which affects up to 40% of breast cancer patients, is the result of diverse patient and treatment factors. The multi-dimensional underlying etiology of fatigue calls for broad based interventions aimed at managing stress, improving diet and exercise patterns and short term cognitive therapy supporting attitudinal and behavioral changes. A pilot study was conducted to obtain preliminary efficacy information for a ten week group-based mind body intervention to treat persistent fatigue among breast cancer survivors. Methods: The quasi-experimental study design used a before/after evaluation of fatigue scores. Subjects were women who were between six months and five years post-completion of adjuvant chemotherapy and/or radiation therapy for breast cancer and who had a baseline fatigue score of ≤ 50 as measured by the vitality subscale of the SF-36 Health Survey. Twenty- one women entered the study. Three participants dropped out after attending only two of the ten weekly sessions and are excluded from the analysis. Main outcome measures were change in severity of fatigue as measured by the Piper Fatigue Scale and vitality subscale score of the SF-36. Results: At baseline, the mean age of participants was 52.7 years; 66.7% were Caucasian and 23.7% were African-American. Median time since breast cancer diagnosis was 2.9 years. The mean Piper fatigue score improved from 6.0 (SD 1.5) at baseline to 4.0 (SD 2.1) at the end of the ten week intervention (p< 0.001). Fatigue scores at two and six months post-intervention were 3.2 (SD 2.9; p= 0.001) and 4.1 (SD 2.1; p= 0.02), respectively. Similarly the SF-36 vitality subscale score improved following the intervention with persistent improvement at 6 months (p=0.02). Conclusion: A holistic integrated mind body medicine intervention holds promise for long-term impact on reducing fatigue following breast cancer treatment. Sponsored by Susan G. Komen Breast Cancer Foundation No significant financial relationships to disclose.

Serum metabolism during breast cancer treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e23043-e23043
Author(s):  
Guro Fanneløb Giskeødegård ◽  
Torfinn Støve Madssen ◽  
Riyas Vettukattil ◽  
Vidar Gordon Flote ◽  
Anders Husøy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Breast Cancer Treatment ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
National Guidelines ◽  
Lipoprotein Subfractions ◽  
Metabolite Profiles

e23043 Serum metabolism during breast cancer treatment Background: Breast cancer treatment may include surgery, systemic therapy and radiation, often involving side-effects. Many patients experience weight gain during treatment, which is associated with decreased survival rates1. The purpose of this study was to describe serum metabolic alterations in breast cancer patients undergoing treatment, and relate these alterations to weight gain during treatment. Methods: This pilot study includes 60 breast cancer patients, aged 35-75 years, with histologically verified stage I/II disease. All patients underwent tumor surgery, and were treated according to national guidelines. Samples were collected before and 6 months after surgery, and analyzed by MR spectroscopy (MRS) and mass spectrometry (MS). 170 metabolites and 105 lipoprotein subfractions were quantified by combined MRS and MS analyses. Results: Multilevel PLS-DA showed significant alterations in serum metabolite profiles post-treatment, both in patients receiving (n = 35) and not receiving (n = 25) chemotherapy (classification accuracy: 86.7% and 77.0%, resp., p < 0.001). Lipoprotein profiles were also significantly altered in both groups (p < 0.001). Chemotherapy recipients had decreased levels of citrate, ornithine, and methionine after treatment, while non-recipients had increased levels of glutamate, alanine, proline and two biogenic amines, and decreased levels of acylcarnitines. 17/52 patients (32.7%) gained weight (≥ 1.5 kg) during treatment. Weight gain was predicted from pre-treatment samples with accuracy 67.0% (p = 0.020). Weight gain patients had lower levels of three acylcarnitines and 20 phosphocholines, and higher levels of lysine and isoleucine, suggesting aberrant lipid and amino acid metabolism. Weight gain was also reflected in the post-treatment samples (accuracy 66.8%, p = 0.015), with weight gain patients having higher levels of five acylcarnitines, and lower levels of glycine, isoleucine and valine. Conclusions: This study indicates that treatment induces changes in serum metabolite levels. Patients gaining weight had significantly different metabolite profiles than those not gaining weight both before and after treatment. 1. Chan et al, Ann Oncol 25: 1901-14, 2014.

scholarly journals Patient Navigation in Breast Cancer Treatment and Survivorship: A Systematic Review

2016 ◽  
Vol 34 (30) ◽  
pp. 3686-3696 ◽  
Author(s):  
Sharon H. Baik ◽  
Linda C. Gallo ◽  
Kristen J. Wells
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Treatment ◽  
Patient Navigation ◽  
Experimental Studies ◽  
Breast Cancer Treatment ◽  
Post Treatment ◽  
Cochrane Library ◽  
Methodologic Quality ◽  
Surveillance Mammography

Purpose Patient navigation is an intervention approach that improves cancer outcomes by reducing barriers and facilitating timely access to cancer care. Little is known about the benefits of patient navigation during breast cancer treatment and survivorship. This systematic review evaluates the efficacy of patient navigation in improving treatment and survivorship outcomes in women with breast cancer. Methods The review included experimental and quasi-experimental studies of patient navigation programs that target breast cancer treatment and breast cancer survivorship. Articles were systematically obtained through electronic database searches of PubMed/MEDLINE, PsycINFO, Web of Science, CINAHL, and Cochrane Library. The Effective Public Health Practice Project Quality Assessment Tool was used to evaluate the methodologic quality of individual studies. Results Thirteen studies met the inclusion criteria. Most were of moderate to high quality. Outcomes targeted included timeliness of treatment initiation, adherence to cancer treatment, and adherence to post-treatment surveillance mammography. Heterogeneity of outcome assessments precluded a meta-analysis. Overall, results demonstrated that patient navigation increases surveillance mammography rates, but only minimal evidence was found with regard to its effectiveness in improving breast cancer treatment outcomes. Conclusion This study is the most comprehensive systematic review of patient navigation research focused on improving breast cancer treatment and survivorship. Minimal research has indicated that patient navigation may be effective for post-treatment surveillance; however, more studies are needed to draw definitive conclusions about the efficacy of patient navigation during and after cancer treatment.

P1361Impact of radiation/chemotherapy for breast cancer on the electroanatomic features in patients receiving catheter ablation for left atrial arrhythmia

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
N Schenker ◽  
N Hashiguchi ◽  
T Maurer ◽  
C Lemes ◽  
L Rottner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Catheter Ablation ◽  
Cancer Treatment ◽  
Left Atrial ◽  
Independent Predictor ◽  
Breast Cancer Treatment ◽  
Control Group ◽  
Study Cohort ◽  
Scar Area ◽  
Significant Difference

Abstract Background Atrial fibrillation (AF) is a common cardiac arrhythmia and catheter ablation a viable treatment option for patients with AF. Extensive left atrial (LA) scars, frequently seen in patients with persistent AF, can limit its efficacy. Radiation for breast cancer treatment is known to have serious long-term effects (e.g. fibrosis) on the targeted tissue. At the same time, chemotherapy often leads to organ dysfunction. We sought to examine the effects of radiation and chemotherapy on the electroanatomic features of the LA in patients who received catheter ablation for left atrial arrhythmias with prior breast cancer treatment. Methods and Results We compared 38 patients (mean age 68.4 ± 7.1 years) who underwent catheter ablation for LA arrhythmia and had a previous diagnosis of breast cancer with 38 patients (mean age 65.4 ± 7.3 years) without breast cancer who formed our control group. LA scar area, as well as its distribution was measured during the electrophysiology (EP) study and graded according to the Utah classification. The existence of LA scarring did not differ significantly between both groups (71.1% vs. 76.3%, p = 0.602). LA scar area (excluding PVs) was 107.5cm2 ± 19.0cm2 in the breast cancer group compared to 110.1cm2 ± 18.5cm2 in the control group (p = 0.536). The distribution of the scar area revealed no significant difference between both groups, however an involvement of the anterior wall was common (65.8% vs. 73.7%; p = 0.454). We further investigated whether the location of breast cancer had an impact on the LA scar development of the patients in our study cohort. Here, we found no significant difference in the amount of LA scarring when comparing patients with left-sided breast cancer to patients with right-sided breast cancer (66.7% vs. 73.9%). In a sub-analysis patients with breast cancer and persistent AF showed a non-significant trend towards greater LA scar areas (17.4cm2 vs. 6.8cm2) in comparison to patients of the control group with similar LA volumes. The patient’s age (&gt;65 years) was the only independent predictor for greater LA scarring we could identify. Neither former radiotherapy, nor chemotherapy showed a positive correlation with greater LA scarring. Conclusion There is no change in the distribution as well as an increase of the extent of LA scars after thoracic irradiation and/or chemotherapy. A trend towards greater LA scar areas was seen in patients with breast cancer and persistent AF. The patient’s age was identified as an independent predictor for LA scar development.

Patient and surgeon correlates of shared decision making for surgical breast cancer treatment

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6031-6031
Author(s):  
S. Hawley ◽  
P. Lantz ◽  
B. Salem ◽  
A. Fagerlin ◽  
N. Janz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Treatment ◽  
Cancer Treatment ◽  
Treatment Decision ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Shared Decision ◽  
Treatment Decision Making ◽  
The Right

6031 Background: The choice of surgical breast cancer treatment represents an opportunity for shared decision making (SDM), since both mastectomy and breast conserving surgery are viable options. Yet women vary in their desire for involvement in this decision. Correlates of SDM and/or the level of involvement in breast cancer surgical treatment decision-making are not known. Methods: Breast cancer patients of Detroit and Los Angeles SEER registries were mailed a questionnaire shortly after diagnosis in 2002 (N = 1,800, RR: 77%). Their responses were merged with a surgeon survey (N = 456, RR: 80%) for a dataset of 1,547 patients of 318 surgeons. Surgical treatment decision making was categorized into: 1) surgeon-based; 2) shared; or 3) patient-based. The concordance between a woman’s self-reported actual and desired decisional involvement was categorized as having more, less, or the right amount of involvement. Decision making and concordance were each analyzed as three-level dependent variables using multinomial logistic regression controlling for clustering within surgeons. Independent variables included patient clinical, treatment and demographic factors, surgeon demographic and practice-related factors, and a measure of surgeon-patient communication. Results: 37% of women reported the surgery decision was shared, 25% that it was surgeon-based, and 38% that it was patient-based. Two-thirds experienced the right amount of involvement, while 13% had less and 19% had more. Compared to women who reported a shared decision, those with surgeon-based decision were significantly (p < 0.05) more likely to have male surgeons, and those reporting a patient-based decision were more likely to have received mastectomy vs. breast conserving surgery. Women who were less involved in the surgery decision than they wanted were younger and had less education, while those with more involvement (vs. the right amount) more often had male surgeons. Patient-surgeon communication was associated with decisional involvement. Conclusions: Correlates of SDM and decisional involvement relating to surgical breast cancer treatment differ. Determining patients’ desired role in decision making may as important as achieving a shared decision for evaluating perceived quality of care. No significant financial relationships to disclose.

scholarly journals Effect of Selected Factors on the Serum 25(OH)D Concentration in Women Treated for Breast Cancer

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 564
Author(s):  
Agnieszka Radom ◽  
Andrzej Wędrychowicz ◽  
Stanisław Pieczarkowski ◽  
Szymon Skoczeń ◽  
Przemysław Tomasik
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Cancer Treatment ◽  
Serum Vitamin ◽  
Study Groups ◽  
Breast Cancer Treatment ◽  
Vitamin D Supplementation ◽  
Control Group ◽  
Average Dose ◽  
Serum Vitamin D

Maintaining an optimal vitamin D concentration reduces the risk of recurrence and extends survival time in patients after breast cancer treatment. Data on vitamin D deficiency among Polish women after breast cancer therapy are limited. Thus, the aim of the study was the analysis of vitamin D status in post-mastectomy patients, considering such factors as seasons, social habits, vitamin D supplementation and its measurements. The study involved 94 women after breast cancer treatment. Serum vitamin D concentration was measured, and a questionnaire, gathering demographic and clinical data regarding cancer, diet, exposure to sun radiation, and knowledge of recommendations on vitamin D supplementation, was delivered twice, in both winter and in summer. The control group consisted of 94 age-matched women with no oncological history. In women after breast cancer treatment, 25-hydroxyvitamin D (25(OH)D) deficiency was much more frequent than in the general population. Only about half of the patients supplemented vitamin D at the beginning of the study. After the first test and the issuing of recommendations on vitamin D supplementation, the percentage of vitamin D supplemented patients increased by about 30% in study groups. The average dose of supplement also increased. None of the women that were not supplementing vitamin D and were tested again in winter had optimal 25(OH)D concentration. It was concluded that vitamin deficiency is common in women treated for breast cancer. Medical advising about vitamin D supplementation and monitoring of 25(OH)D concentration should be improved.

Lymphaticovenular Anastomosis in Breast Cancer Treatment-Related Lymphedema: A Short-Term Clinicopathological Analysis from Indonesia

2021 ◽  
Author(s):  
Bayu Brahma ◽  
Rizky Ifandriani Putri ◽  
Jauhari Oka Reuwpassa ◽  
Yustia Tuti ◽  
Muhammad Farid Alifian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Diagnostic Methods ◽  
Lower Grade ◽  
Axillary Lymph ◽  
Subjective Symptoms ◽  
Invasive Approach ◽  
The Mean

Abstract Background Locally advanced breast cancer is commonly found in Indonesia. In this group of patients, aggressive treatment such as axillary lymph nodes dissection (ALND) with or without regional nodal irradiation (RNI) will increase the risk of breast cancer treatment-related lymphedema (BCRL) in our patients. Lymphaticovenular anastomosis (LVA) has been established as a minimally invasive approach in lymphedema surgery. In this study, we report our first experience of LVAs in BCRL patients. Methods This was a cross-sectional study taken from breast cancer patients receiving ALND with or without RNI. From December 2018 until June 2020, we collected and described general patient information, tumor characteristics, diagnostic methods, and the outcome of LVA. Postoperative subjective symptoms scores (lymphedema quality-of-life score [LeQOLiS]) and lymphedematous volume (upper extremity lymphedema [UEL] index) were compared with preoperative ones. Results Seventy patients experienced BCRL with the mean age of 54.8 (9.4) years and mean body mass index of 28.1 (4.5). ALND was performed in 66 (97.1%) cases and RNI was given in 58 (82.9%) patients. Thirty-one (44.3%) patients were in the International Society of Lymphology stage 1, 24 (34.3%) in stage 2A, and 15 (21.4%) in stage 2B. The mean lymphatic vessel diameter was 0.5 (0.26) mm and 0.80 (0.54) mm for the vein. Lymphosclerosis severity was 7 (4%) in S0 type, 129 (74.1%) in S1 type, 37 (21.3%) in S2 type, and 1 (0.6%) in S3 type. In histopathology examination, S1 types were in lower grade injury, while S2 and S3 types were in the higher grade. Seven (53.8%) cases of S2 type showed severe fibrosis from trichrome staining. Postoperative LeQOLiSs were significantly lower than preoperative ones (5.6 ± 2.4 vs. 3.7 ± 2.6; p = 0.000). With the mean follow-up of 7.4 (3.7) months, the overall UEL index reduction was 9.2%; mean –11 (16.8). Postoperative UEL index was significantly lower than preoperative ones (117.7 ± 26.5 vs. 106.9 ± 18.5; p = 0.000). No complications were observed during this period. Conclusion LVA reduced the subjective symptoms and UEL index in BCRL cases. Future studies using updated imaging technologies of the lymphatic system and longer follow-up time are needed to confirm our results.

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