Musculoskeletal, cardiorespiratory, anthropometric and sensorial changes following breast cancer surgery

Abstract Introduction: Breast cancer is the second most common malignant neoplasm in women. Surgical intervention is one of the recommended treatments, which can lead to significant physical and sensorial sequelae. Objective: To analyze the musculoskeletal, cardiorespiratory, anthropometric and sensorial functions of women who underwent breast cancer surgery. Methods: An observational, cross-sectional study with women who underwent surgical resection of breast tumors at Amaral Carvalho, a reference hospital in the countryside of the São Paulo State, Jaú/SP, Brazil. Three assessments were obtained: pre-surgery (Ass1), one day after the surgery (Ass2) and 15 days after surgery (Ass3). Sociodemographic and gynecological data were collected, and anthropometric, cardiovascular, dermal sensitivity, range of motion (ROM) of the upper limbs, peripheral oxygen saturation (SpO2), inspiratory muscle strength (PImax), peak expiratory flow (PEF) and thoraco-abdominal mobility assessments were performed. Data were evaluated by repeated measures ANOVA and Wilcoxon statistical test with a Bonferroni correction (p < 0.05). Results: Eighteen women, with a mean age of 57.44 ± 9.35 years, mainly with the left side affected (61.1%) and lymphadenectomy performed in 50% of the cases. Differences were found in systolic and diastolic blood pressure, PEF and SpO2, axillary ROM index (Ass1>Ass2), PImax (Ass3>Ass2), perimetry (Ass2>Ass3), ROM in all axes of shoulder motion and wrist flexion (Ass2Ass2 and Ass1). Conclusion: The surgery for breast cancer excision resulted in hemodynamic and respiratory changes, especially on the first day after the procedure, returning to baseline values approximately 15 days later.

【摘要 引言】乳腺癌是女性第二大常见恶性肿瘤。手术干预是临床推荐的治疗手段之一，但可引发显著的躯体及感觉后遗症。
目的：分析接受乳腺癌手术的女性患者的肌肉骨骼、心肺、人体测量学及感觉功能状态。
方法：本研究为观察性横断面研究，研究对象为巴西圣保罗州内陆转诊医院Amaral Carvalho（若奥市/圣保罗州）接受乳腺肿瘤手术切除的女性。共开展3次评估：术前（评估1，Ass1）、术后1天（评估2，Ass2）及术后15天（评估3，Ass3）。收集社会人口学及妇科相关资料，并开展人体测量学、心血管、皮肤敏感度、上肢活动度（Range of Motion, ROM）、脉搏血氧饱和度（Peripheral Oxygen Saturation, SpO2）、吸气肌力量（Inspiratory Muscle Strength, PImax）、呼气峰流速（Peak Expiratory Flow, PEF）及胸腹部活动度评估。数据采用重复测量方差分析及经Bonferroni校正的Wilcoxon检验进行分析，检验水准设为p<0.05。
结果：共纳入18名女性患者，平均年龄为57.44±9.35岁，左侧乳腺受累者占比61.1%，50%的病例接受了淋巴结清扫术。研究发现收缩压、舒张压、PEF及SpO2存在组间差异；腋窝活动度指数表现为评估1>评估2；PImax表现为评估3>评估2；周径测量值表现为评估2>评估3；肩关节各活动轴及腕屈活动度在评估2与评估1间存在差异。
结论：乳腺癌切除手术可引发血流动力学及呼吸功能改变，尤其以术后首日最为显著，上述指标约在术后15天恢复至基线水平。