Management of physical therapy after chemotherapy extravasations: case report

Abstract

Objective: This study aimed to present the role of physiotherapy after chemotherapy extravasation. Patient G.M.M.S,
75 years old, diagnosed with breast cancer, during her first session of vesicant chemotherapy via port-a-cath, experienced a burning sensation in the breast. She reported this to the team who asked her to stay under observation. After 24 h,
she developed swelling, redness, and pain in the region. Over the following days, her condition worsened, requiring hospitalization and antibiotic treatment. Due to the extravasation, she continued chemotherapy treatment intravenously.
Six months after the incident, she sought physiotherapy reporting a sensation of hardening, swelling, and discomfort in the
breast area. Upon physical evaluation, she presented with 14 cm of fibrosis in the breast, significant edema, dilated pores,
red and purplish skin, and pain rated at 6 on the Numerical Rating Scale. Methodology: Ten physiotherapy sessions two
times per week were conducted with the aim of reducing fibrosis, edema, and pain. The approach included manual therapy in the fibrosis region, infrared photobiomodulation, shockwave therapy, and compressive taping. Results: After 10
sessions, there was a reduction in fibrosis to 7 cm, decreased edema, and no more pain. The patient continues with treatment. Conclusion: Physiotherapy offers therapeutic resources that can help reduce the inflammatory process, remodel
fibrosis, and provide analgesia in tissue changes caused by extravasation.