Análise da volumetria de membros superiores e sua relação com o ganho funcional em pacientes submetidas à cirurgia oncológica mamária

Abstract

Introduction: The treatment for breast cancer can generate several complications, including lymphedema, a complex condition, with a multifactorial etiology, as well as a reduction in the functional capacity to perform tasks with the upper limbs (ULs). Objective: To analyze the UL volume and the presence of lymphedema before and after physical therapy intervention in women after breast cancer surgery and correlate them with functional gains. Method: A quantitative, longitudinal research, with 30 women who underwent breast cancer surgery, referred to physiotherapy, and with UL circumference measurement and indirect volume calculation; and the disabilities of the arm, shoulder and hand (DASH) questionnaire, before and after four months of physical therapy intervention. Circumference measurements were performed every 5 centimeters from the wrist bend, with a total of 9 points along the ULs. Results: In the limb on the same side of the surgery, the volumetric measurements decreased between the assessments (p = 0.042), as well as the difference in volume between homolateral and contralateral limbs (p <0.05). The DASH questionnaire also had its score reduced (p = 0.048) showing an increase in the functional capacity of ULs. There was a strong correlation between volume gains and better DASH scores (r = -0.804) in patients with lymphedema. Conclusion: The indirect volumetric analysis in the ULs showed a predominance of lymphedema of minimal and mild severity, however, functional capacity and volume reduction were strongly correlated after the physical therapy intervention.