Functional rehabilitation of the upper limb in the post-operative mastectomy

Abstract

Breast cancer treatments can be divided into systemic, consisting of chemotherapy, hormone therapy and biological therapy, and local treatment, which refers to surgical procedures and radiotherapy. In some cases, surgical treatment (mastectomy) is necessary to prevent the cancer from spreading to other areas of the body. Oncological physiotherapeutic treatment is relevant from the pre-operative period, occurring in the identification of existing changes and post-surgical rehabilitation, establishing specific instructions for each individual. This study aims to present physiotherapeutic approaches used to treat patients after total or partial mastectomy, with an emphasis on functionality in the ipsilateral upper limb following the surgical procedure. A bibliographic review of the literature was included, analyzing physical therapy interventions of manual lymphatic guidance versus active exercise, pilates, kinesiotherapy, inertial training, progressive exercises for MS and muscle relaxation training, hydrotherapy, virtual reality, BTX-A infiltrated into the pectoralis major muscle and ultrasound-guided trigger point injection into the pectoralis major muscle. The results found demonstrate that physiotherapy plays an important role in the return of upper limb functionality after mastectomy. These findings highlight the importance of early rehabilitation in recovering shoulder ROM after surgery. It is possible to conclude that physiotherapy interventions have been shown to be effective in improving upper limb functionality and symptoms after mastectomy.