Breast cancer: how to address possible sequelae after surgery with physiotherapy

Can physiotherapy help treat swelling that appears after surgery and breast cancer treatment?It is possible that, during treatment, words such as lymphedema and manual lymphatic drainage appear.What do these terms mean and what relationship with breast cancer?

Breast cancer, one of the most frequent

In Spain they were diagnosed, during the year 2020, almost 35.000 new cases of breast cancer, thus being in the most frequent tumor among the women of our country.As the European Cancer Information System (ECIS) corroborates, approximately 30% of cancers diagnosed in women originate in the breast, a type of cancer that already have an incidence rate of about 132 cases per 100.000 inhabitants, especially in women between 35 and 80 years old.

If one takes into account that women with breast cancer have a 77% probability of surviving at least ten years, effective prevention and treatment of possible complications are key to dealing with side effects, such as lymphedema, aOf the main complications of this type of cancer.

In this sense, on the occasion of the International Day against Breast Cancer held this October 19, from the rehabilitation service of the Infanta Elena de Valdemoro University Hospital, they want to highlight precisely the importance of the early intervention of physiotherapists in order toreduce the side effects of both breast cancer and treatments that are received.

Lymphedema, another challenge in breast cancer care

Just below the skin we have an extensive network of lymphatic vessels that help the body eliminate toxins and other unwanted materials.These vessels, as part of the lymphatic system, filter the liquid through the lymph nodes and then carry the clean liquid, which contains white blood cells that fight infections, all over the body.

Lymphedema is an abnormal accumulation of this liquid.30% of the almost 11.000 Spanish women who submit each year to a mastectomy suffer from a lymphedema, according to data from the General College of Physiotherapist Colleges of Spain (CPFCM).This inflammation, produced by liquid accumulation because the lymphatic system does not drain in the right way, is one of the main complications after breast cancer surgery.

Also often, during the treatment of this type of cancer, some or all axillary lymph nodes are treated with radiation.What is done with this treatment is drain.

Pain in the extremities and shoulders, heaviness, oppression and decrease in the range of movement are some of the main symptoms that usually appear.Also motor skills can be affected, which directly affects the ability to perform some of the daily and everyday functions, which in many cases are restricted.

If not due, secondary lymphedema, a progressive chronic condition, it can worsen and it is possible that a series of permanent changes in tissues appear.Therefore, receiving immediate treatment is key to reducing the risk of infections and complications.

The role of physiotherapists

Physiotherapists play a fundamental role in the treatment of these problems and their intervention can make a difference in people's quality of life."We treat the surgical scar, the appearance of fibrosis, the limitation in the movement of the arm, educate in automation and postural standards and prevent or treat the lymphedema in the upper limb," recognize the specialists of the Valdemoro hospital, who work to promote theLymphedema prevention.

Work focuses on two lines: prevention and treatment.Prevention includes information and health education to follow at a day -to -day life at home or at work.When the lymphedema has already appeared, the work focuses on a complex physical therapy (manual drainage of the area, application of containment and retaining bandage).

In an exhaustive review it is demonstrated that physiotherapy is promising in the treatment of lymphedema, especially complex decongestive therapy, which is the one that receives the most evident scientific evidence.The review also concludes that the benefit is even greater when physiotherapy begins early.

Therefore, it is key throughout the process to guarantee rapid access to specialized physiotherapists so that they can provide education and resources to the patient.The physiotherapist thus becomes an active educator in the work of improving the quality of life of patients and their self -care capacity.