October is Breast Cancer Awareness Month!
Breast cancer is one of the three most common cancers worldwide. It affects not only women, but also men. One in eight to ten women will get breast cancer at some point in her lifetime.
Warning signs of breast cancer include:
- feelings of a lump or mass in the breast,
- breast or nipple pain,
- breast swelling,
- nipple retraction,
- nipple discharge,
- skin dimpling on breast,
- and redness or thickening of breast or nipple skin.
Non-modifiable breast cancer risk factors include:
- being female,
- genetic mutations known to cause breast cancer,
- increasing age,
- family history,
- early menses,
- and late menopause.
Some modifiable risk factors include: obesity, physical activity, and increased alcohol consumption.
The American Cancer Society Guidelines for Screening:
The American Cancer Society updated its guidelines in 2015 to state that for women at “average risk” for breast cancer, the start of yearly mammograms should begin at age 45 and change to every other year by the age of 55. Women are classified as “average risk” if they don’t have a personal history of breast cancer, a strong family history of breast cancer, no chest radiation before the age of 30, or a genetic mutation known to increase the risk of breast cancer. Breast exams are not included in the updated recommendations because of lack of evidence of their benefit. However, the American Cancer Society states women should be familiar with how their breasts look and report any changes to their healthcare providers.
The Role of Physical Therapy in Improving Quality of Life in Individuals Affected by Breast Cancer:
Screening and treatment of breast cancer continues to improve resulting in increased survival rate. However, this may lead to many survivors living with a decreased quality of life due to side effects of treatments. Physical therapy can help improve quality of life after a breast cancer diagnosis and treatment when cleared by physicians.
Post-operative upper limb impairments such as reduced shoulder mobility, reduced upper limb strength, increased swelling of the upper extremity due to lymphedema, and pain can be improved with active stretches, exercises, and manual lymphatic drainage provided by a physical therapist. Supervised exercise from a physical therapist well versed in oncology can also potentially improve cancer related fatigue, pain, and help maintain a healthy weight associated with improved breast cancer prognosis.
Exercise may also help to counteract the effects of chemotherapy induced peripheral neuropathy through improving balance, decreasing falls, improving walking speed, and improving lower extremity strength. Urinary incontinence that may be more prevalent among cancer survivors including breast cancer, can be helped through conservative treatments provided by a physical therapist specialized in pelvic health such as pelvic floor muscle exercises, bladder retraining, and lifestyle modifications.
The Importance of a Supportive Communicative Team of Providers
Breast cancer effects do not end with cure. Maintaining quality of life during active breast cancer and survivorship is of the utmost importance. Many other support services can also help improve quality of life for individuals affected by breast cancer such as mental health professionals, nutritionists, and support groups. An important factor is that individuals affected by breast cancer feel they have a supportive communicative team of providers.
With an Open Learning Mind,
Simon, Stacy (2015, October 20). American cancer society releases new breast cancer guidelines. American Cancer Society. Retrieved from https://www.cancer.org/latest-news/american-cancer-society-releases-new-breast-cancer-guidelines.html.
Groef A, Van Kampen M, Dieltjens E, et al. Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review. Archives of Physical Medicine and Rehabilitation. 2015;96(6):1140-1153.
Cho Y, Do J, Jung S, et al. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support Care Cancer. 2016 May;24(5):2047-2057.
Imayama I, Alfano C, Neuhouser M, et al. Weight, inflammation, cancer-related symptoms and health-related quality of life among breast cancer survivors. Breast Cancer Res Treat. 2013; 140(1): 159-176.
Hutchinson N, Deval N, Rabusch S, et al. Physical therapy based exercise protocol for cancer patients: evaluating outcomes for cardiopulmonary performance and cancer related fatigue. PMR. 2019;11(11): 1178-1183.
Duregon F, Vendramin B, Bullo V, et al. Effects of exercise on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: A systematic review. Crit Rev Oncol Hematol. 2018 Jan;121:90-100.