Physiotherapy in the immediate post-operative breast cancer: A primary care proposal

Abstract

Objective: The aim of this study was to verify whether the primary care strategies carried out by physiotherapy in the
immediate postoperative period of breast cancer are effective. Methodology: This is a retrospective study of consultations carried out in the breast ward by the physiotherapy service, including screening of consultations from February 2019
to February 2023. The data analyzed were age, education, marital status, parity, hormonal status, diagnosis, dominant
limb, type of surgery, condition of the scar, need for referral to physiotherapeutic care, and the physiotherapeutic strategies adopted at that time. The study was approved by the Brazil Platform (CAAE 56561222.9.0000.0084). Results: A total of
122 files were analyzed, and 12 (9.8%) were excluded due to missing data; the mean age was 51.66±16.2 years, 31 (28%) had
completed high school, 43 (39%) were married, 26 (23%) were nulliparous, and 58 (51%) underwent menopause. As for the
diagnosis, 78 (70%) discovered it through self-examination and only 28 (25%) through mammography, 45 (40%) had cancer on the dominant side. Quandrantectomy was the most common surgical type in 40 (36%), followed by sectorectomy in
21 (19%), and lymph node dissection was present in 11 (10%). Inflammatory signs were not identified in 58 (52.7%), and 69
(62.7%) were referred for physiotherapy. All women were instructed to freely maintain upper limb movements and taught
to perform simple free active movements at home for the prevention of lymphedema, being reinforced by the delivery of
educational material. After a week, it was observed that all of them had no signs of lymphedema and or upper limb movement loss. Conclusion: The performance of physiotherapy in the immediate postoperative period is extremely relevant
in caring for the scar/hydration of the skin and in stimulating free active exercise that may prevent the development of
lymphedema or even functional limitation due to kinesiophobia. Delivery of educational material, as well as physiotherapeutic follow-up at the time of chemotherapy/radiotherapy, enhances the positive results.