title: Early rehabilitation reduces the onset of complications in the upper limb following breast cancer surgery.
abstract: BACKGROUND
  Breast cancer (BC) is currently the most frequent tumor in women. Through the years, BC management has evolved towards conservative surgery. However, even minimally invasive surgery can cause neuromotor and/or articular impairments which can lead to permanent damage, if not adequately treated.
  
  
  OBJECTIVE
  To clinically evaluate upper ipsilateral limb function and the impact of certain post-surgical consequences arising after invasive or breast-conserving surgery for early BC, by intervening, or not intervening, with an early rehabilitation program. To investigate physical morbidity after sentinel (SLND) or axillary lymph node dissection (ALND) and after reconstructive surgery in the treatment of early BC.
  
  
  METHODS
  Observational prospective trial.
  
  
  METHODS
  Inpatient and outpatient treatment.
  
  
  METHODS
  Eighty-three females participated in the study: 25 patients did not begin physiotherapy during hospitalization (Group A), 58 patients received early rehabilitation treatment (Group B).
  
  
  METHODS
  The patients of Groups A and B were compared with respect to the following criteria: shoulder-arm mobility, upper limb function, and presence of lymphedema. All patients were assessed at 15-30, 60 and 180 days after surgery.
  
  
  RESULTS
  Statistically significant differences, in favor of Group B, were encountered at the 180-day follow-up visit, especially with respect to articular and functional limitation of the upper limb.
  
  
  CONCLUSIONS
  The results of the present study show that early assisted mobilization (beginning on the first postoperative day) and home rehabilitation, in conjunction with written information on precautionary hygienic measures to observe, play a crucial role in reducing the occurrence of postoperative side-effects of the upper limb.
authors.affiliation: Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, La Sapienza University of Rome, Rome, Italy. m.scaffidi@yahoo.it
authors.forename: M
authors.initials: M
authors.lastname: Scaffidi
authors.forename: M C
authors.initials: MC
authors.lastname: Vulpiani
authors.forename: M
authors.initials: M
authors.lastname: Vetrano
authors.forename: F
authors.initials: F
authors.lastname: Conforti
authors.forename: M R
authors.initials: MR
authors.lastname: Marchetti
authors.forename: A
authors.initials: A
authors.lastname: Bonifacino
authors.forename: P
authors.initials: P
authors.lastname: Marchetti
authors.forename: V M
authors.initials: VM
authors.lastname: Saraceni
authors.forename: A
authors.initials: A
authors.lastname: Ferretti
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000502:physiology / Q000503:physiopathology; D001943:Breast Neoplasms / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007558:Italy; D008197:Lymph Node Excision / Q000009:adverse effects / Q000534:rehabilitation*; D016462:Mammaplasty / Q000009:adverse effects / Q000534:rehabilitation*; D015409:Mastectomy, Radical / Q000009:adverse effects / Q000534:rehabilitation*; D015412:Mastectomy, Segmental / Q000009:adverse effects / Q000534:rehabilitation*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control* / Q000534:rehabilitation; D011446:Prospective Studies; D055502:Secondary Prevention / Q000379:methods; D012785:Shoulder Joint / Q000502:physiology / Q000503:physiopathology