The effects of mastectomy on the structure and function of the musculoskeletal system and their treatment with physical therapies – A review of the literature.
Item
- Title
- The effects of mastectomy on the structure and function of the musculoskeletal system and their treatment with physical therapies – A review of the literature.
- Author(s)
- Young, A
- Abstract
- Introduction Mastectomy is the recommended treatment for early invasive, locally advanced or inflammatory breast cancer, and sometimes in situ disease such as ductal carcinoma in situ (DCIS). Around 48,400 cases of breast cancer are diagnosed in women every year in the UK and four out of ten of these undergo mastectomy. The aim of this dissertation is to review the musculoskeletal (MSK) effects of surgical removal of a breast, with or without reconstruction. Where MSK sequelae are shown to exist, evidence for the treatment of these conditions using physical therapies will be presented. Methods This literature review was conducted using online journal databases accessed via Greenwich University Portal and PubMed. Search terms incorporating Boolean logic and keywords were used. For example: mastectomy AND musculoskeletal effects. Specific MSK conditions were then further resourced, again using Boolean logic and keywords. In addition, books were used to gather further relevant information. Results A number of MSK conditions have been shown to result from mastectomy, such as post mastectomy pain syndrome, muscle weakness, central sensitization, lymphoedema, axillary web syndrome and myofascial trigger points. There is also some evidence of changes in scapulae kinematics, altered body posture and chronic pain in the shoulder, neck, arm and back. Clinical practice guidelines are lacking for the treatment of upper extremity impairments following mastectomy, but trials have shown that intensive and comprehensive physiotherapy programmes are effective in reducing neck and shoulder pain after surgery, and increasing arm and shoulder range of motion. Discussion There is a gap in the literature regarding rib dysfunction following breast cancer. Osteopathic principles state that structure and function are interrelated at all levels, so it is proposed that structural changes to the breast and chest can affect how the ribs and spine function, It is hypothesised that osteopathy can help in treating many of the MSK conditions resulting from mastectomy. Conclusion Mastectomy does have an effect on the structure and function of the MSK system and this can lead to chronic pain in some patients. More longitudinal studies are needed to see whether the effects of rehabilitation programmes last, and to determine which elements of these are most effective so that manual therapists can implement them in their treatment plans
- presented at
- European School of Osteopathy
- Date Accepted
- 2013
- Date Submitted
- 20.1.2015 16:42:59
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 15482
- Inst-Identifier
- 1229
- Keywords
- Mastectomy.
- Recommended
- 0
- Item sets
- Thesis
Young, A, “The effects of mastectomy on the structure and function of the musculoskeletal system and their treatment with physical therapies – A review of the literature.”, Osteopathic Research Web, accessed May 17, 2024, https://www.osteopathicresearch.com/s/orw/item/682