Tratamento fisioterápico em pacientes pós mastectomia

Abstract

According to the World Cancer Report 2014, the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO), the cancer is a public health problem, particularly among the developing countries, with impact on the population to 80% of the more than 20 million new cases estimated until 2025. Cancer is one of the leading causes of death worldwide, being responsible for about 9.6 million deaths in 2018. The breast cancer control is a priority for the health agenda in Brazil. Cancer, considered multifactorial, because they involve biological factors and endocrine, reproductive life, behavior and life style. The aging, the factors related to women's reproductive life, family history of cancer, the high density of breast tissue, are the major risk factors for the growth of breast cancer. Add to that, the consumption of alcohol, excess weight, a sedentary lifestyle and exposure to ionizing radiation, are considered as potential agents for the development of cancer. Objective: To evaluate the effectiveness of the physiotherapeutic treatment in patients after mastectomy. Materials and Methods: a pilot study, randomized, open, with three treatment groups. The sample consisted of 12 patients with breast cancer for 0 to 5 days postoperatively of mastectomy, from Santa Casa de Misericórdia de Sobral, not being made restrictions on ethnic group, referred to physiotherapy treatment, carried out for a period of 15 days. They were included in the study in the past 12 months and met the selection criteria, the judgment of the researchers authorised in this protocol, based on clinical history and examination, who signed the Informed Consent Form. Results: The efficacy of the physiotherapeutic treatment was evaluated by the improvement of pain, lymphedema and articular amplitude, in adhesive capsulitis of the shoulder, measured between the basal period (V1), in the third (V2), sixth (V3), Ninth (V4), twelfth (V5) and on the fifteenth day (V6), compared between the three groups. The temporal assessment of pain intensity, functional capacity, the lymphedema, by means of the measure in cm, the perimeter in points 1 to 6 of the ipsilateral upper limb, and more, the temporal evaluation of amplitude, in degrees, of the movement of flexion, abduction movement, the adduction movement, the movement of extension, the ipsilateral upper limb to the surgical procedure in patients mastectomized, submitted to physiotherapeutic treatment, in which comparisons were made between the different evaluation visits, through the use of analysis of variance (ANOVA) for repeated measures complemented by the multiple comparison test of Dunnet's test, to check for differences between the views of the stage of treatment (V1 to V6) and the visit of pretreatment (V0), showed a statistically significant difference ***(P<0.001) in relation to the visit 0 (V0). Key words: Physical Therapy Specialty. Breast Neoplasms. Bursitis. Unified Health System.