• 제목/요약/키워드: Post-mastectomy patients

검색결과 46건 처리시간 0.022초

4주간의 PNF기법을 이용한 어깨뼈 안정화 운동이 유방암 절제술을 한 여성의 어깨뼈 대칭성, 어깨관절 굽힘 가동범위, 통증 및 기능, 삶의 질에 미치는 영향 (The Effect of a Four-week Scapular Stabilization Exercise Program using PNF technique on Scapular Symmetry and Range of Flexion Motion, Pain, Function, and Quality of life in Post-Mastectomy Women with Breast Cancer)

  • 송민정;강태우
    • PNF and Movement
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    • 제19권1호
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    • pp.19-29
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    • 2021
  • Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.

유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램 효과 (Effectiveness of Individualized Upper Extremity Exercise Program for Patients after Mastectomy)

  • 임경희
    • 한국산학기술학회논문지
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    • 제19권10호
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    • pp.313-323
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    • 2018
  • 본 연구의 목적은 유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램을 개발하여 적용하고 그 효과를 검증하기 위한 것이다. 연구설계는 유사실험설계이며, 연구대상은 D지역의 2개 대학병원에서 유방절제술을 받은 3년 이내의 환자로 실험군 17명, 대조군 16명이 연구에 참여하였다. 본 연구에 참여하는 실험군에게는 2015년 6월부터 7월동안 총 주 3회의 운동프로그램을 7주간 실시하였고, 대조군에게는 운동프로그램을 제공하지 않았다. 본 연구 프로그램의 사전, 사후 어깨관절 유연성은 줄자를 이용한 등 뒤 손잡기와 관절 각도계를 이용한 어깨가동범위를 측정하였으며, 악력은 악력계를 이용하여 측정하였다. 자료 분석은 SPSS/Win 21.0 program을 이용하였고, 사전 동질성 검증은 카이제곱 검정과 Fisher's exact test, Mann-Whitney U-test를 이용하였으며, 가설 검증은 Mann-Whitney U-test, Wilcoxon Signed Rank test를 이용하였다. 연구결과, 맞춤형 상지 운동프로그램에 참여한 실험군은 대조군에 비해 등 뒤로 두 손 마주잡기(p=.001), 굽힘(p<.001), 벌림(p=.032), 바깥돌림(p=.024), 안쪽돌림(p=.041) 등에서 모두 유의한 변화를 나타내 유연성과 관절가동범위가 증가한 것으로 나타났다. 또한 실험군은 대조군에 비해 악력(p<.001)도 유의하게 증가한 것으로 나타났다. 본 연구에서 개발된 개별 유방암 환자의 특성과 신체적 상태를 고려하여 과부하의 원리와 점증적 원리로 구성된 유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램은 수술 후 환자들의 어깨관절 유연성과 악력 향상에 효과적이었으며 수술 후 많은 환자들이 호소하는 어깨관절 기능 및 악력 저하를 예방하고 신체기능을 향상시켜 일상생활로의 복귀를 도와줄 수 있을 것으로 기대된다.

Young Women with Breast Cancer in the United States and South Korea: Comparison of Demographics, Pathology and Management

  • Son, Byung Ho;Dominici, Laura S;Aydogan, Fatih;Shulman, Lawrence N;Ahn, Sei Hyn;Cho, Ja Young;Coopey, Suzanne B;Kim, Sung Bae;Min, H Elise;Valero, Monica;Wang, Jiping;Caragacianu, Diana;Gong, Gyung-yub;Hevelone, Nathanael D;Baek, Seunghee;Golshan, Mehra
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2531-2535
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    • 2015
  • Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.

Benefit of Post-mastectomy Radiotherapy of the Supra-/infraclavicular Lymphatic Drainage Area in Breast Cancer Patients

  • He, Zhen-Yu;Wu, San-Gang;Zhou, Juan;Sun, Jia-Yuan;Li, Feng-Yan;Lin, Qin;Guo, Ling;Lin, Huan-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5557-5563
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    • 2014
  • Background: This study investigated the survival benefit of radiotherapy (RT) of the supra- and infraclavicular lymphatic drainage area in Chinese women with T1-2N1M0 breast cancer receiving mastectomy. Methods: A total of 593 cases were retrospectively reviewed from 1998 to 2007. The relationship between supra- or infraclavicular fossa relapse (SCFR) and post-operative RT at the supra-/infraclavicular lymphatic drainage area was evaluated. Results: The majority of patients (532/593; 89. 8%) received no RT while 61 patients received RT. The median follow-up was 85 months. Among patients without RT, 54 (10. 2%) developed recurrence in the chest wall or ipsilateral SCFR. However, none of the 61 patients who underwent RT demonstrated SCFR. One patient who received RT (1. 6%) experienced recurrence in the chest wall. Univariate analysis revealed that age and molecular subtype (both P < 0. 05) were two prognostic factors related to supraclavicular and infraclavicular fossa relapse-free survival (SFRFS). Multivariate analysis revealed that only Her-2 positive status (P = 0. 011) was an independent predictor of SFRFS. RT had no influence on distant metastasis (P = 0. 328) or overall survival (P = 0. 541). SCFR significantly affected probability of distant metastasis (P < 0. 001) and overall survival (P < 0. 001). Conclusion: Although RT was not significantly associated with SFRFS, postoperative RT was significantly associated with a lower locoregional (i. e., supraclavicular/infraclavicular and chest wall) recurrence rate. SCFR significantly influenced distant metastasis-free survival, which significantly influenced the overall survival of T1-2N1M0 breast cancer patients after mastectomy. Thus, prophylactic RT is recommended in T1-2N1M0 breast cancer patients, especially those who have Her-2 positive lesions.

유경횡복직근피판을 이용한 유방절제술 후 지연재건 150례 및 결과 (150 Consecutive Cases of Delayed Post Mastectomy Reconstruction with TRAM Flap and Results)

  • 정인욱;이택종
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.19-26
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    • 2011
  • Purpose: This is the report on the results of 150 consecutive cases of delayed postmastectomy reconstruction with TRAM flap performed by single surgeon. The purpose of this study is to review the merits, demerits and other considerations of this method by analyzing the results. Methods: 150 patients were reviewed retrospectively who had breast reconstruction by a single surgeon from July 2001 to July 2008. Reviewed factors include demographic factors, mastectomy method, adjuvant therapies (such as radiation, chemotherapy) complication rate, simultaneous contralateral breast procedure rate, secondary touch-up procedure rate, and patients' satisfaction. Results: Ovarall TRAM flap complication rate was 22.6%. Among them, donor site complication rate was 36%, simultaneous contralateral breast procedure rate was 44.6%, secondary touch-up procedure rate was 40%. All rates were higher compared to immediate reconstruction with TRAM flap. But the patients' satisfaction was about the same as immediate reconstruction. Conclusion: Delayed postmastectomy reconstruction with TRAM flap can yield satisfactory results despite of relatively high complication rate and concomitant procedure rate when it is performed by a experienced surgeon.

암 극복 베하스운동 프로그램이 유방암 환자의 위기와 불안에 미치는 효과 (Effects of a Cancer-Overcome BeHaS Exercise Program on Post-trauma Risk and Anxiety in Breast Cancer Patients)

  • 김선애;김종임;박선영
    • 근관절건강학회지
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    • 제21권1호
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    • pp.27-35
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    • 2014
  • Purpose: The purpose of this study was to estimate the effects of a cancer-overcome BeHaS exercise program on post-trauma risk and anxiety in breast cancer patients. The cancer-overcome BeHaS exercise program consisted of exercise, education, and cognitive supports. Methods: A one group pretest-posttest experimental design was used for this study. Fourteen mastectomy patients, the subjects of the group participated in the BeHaS exercise program. The program was provided for 8 weeks, once a week in C hospital. Data were collected from October to November 2012 with self report structured questionnaires. Descriptive statistics, and Wilcoxon Signed Rank test were used to analyze data with the SPSS 19.0. Results: The mean age of participants was 53 and the mean postoperative period after the surgery was 18.64 months. After the BeHaS exercise program, while there was no significant decrease in post-trauma risk scores, there was a significant difference in anxiety (z=-2.20, p=.028). Conclusion: This program has effects on decreasing anxiety in patients with breast cancer. Therefore the BeHaS exercise program should be applied as a nursing intervention to reduce anxiety for the patients with breast cancer.

유방절제술 환자의 상지감각변화와 삶의 질 (Changes in Upper Extemity Sensation and the Quality of Life for Patients Following Mastectomy)

  • 이숙정;박영미;김지영
    • 종양간호연구
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    • 제11권3호
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    • pp.229-236
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    • 2011
  • Purpose: The purpose of this study was to examine the sensation changes in upper extremity and the quality of life for post-operative mastectomy patients. Methods: This study used a descriptive study design. The participants were 132 women who had mastectomies after being diagnosed with breast cancer and were participating in breast cancer self-help groups. The sensation changes in the arm of the surgery site was measured by the arm symptoms which were subjective uncomfortable feelings of the affected arm, and the quality of life was measured by Medical Outcomes Study Short Form-36. Collected data were analyzed by ANOVA, t-test, ${\chi}^2$-test and multiple regression with SPSS WIN 12.0 program. Results: Patients with stage IV breast cancer had severe changes in sensation of the arm. Participants with lymphedema had statistically significant changes in sensation compared to participants without lymphedema, but the quality of life was not different between the two groups. Pain by the SF 36 was statistically different between the two groups, with- and without-lymphedema. The factors in upper extremity's sensation changes which influence on quality of life were pain and heaviness. Conclusion: Nursing intervention for relieving pain and heaviness of the affected arm needs to be developed in order to improve QOL of the breast cancer survivors.

Effects of Skin Mobilization on Pain and Joint Range Improvement in Patients with Axillary Web Syndrome: A Single Case Report

  • Choi, Suhong;Lee, Sangyeol
    • Physical Therapy Rehabilitation Science
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    • 제10권2호
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    • pp.112-115
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    • 2021
  • Objective: This study was conducted to apply skin mobilization to patients with Axillary web syndrome following breast cancer resection and to see the resulting changes in pain and joint range of motion. Design: Single case study,pre-post comparison. Methods: The subject was a female patient in her 40s who performed a mastectomy after being diagnosed with breast cancer, and then complained of uncomfortable pain from the shoulder joint to the axilla and limited range of motion. To implement a skin mobilization, the palms were adhered to the inner half of the arm, the arms were raised to a pain-free extent, and skin mobilization was performed. The skin was pulled in the direction of axilla and kept for 5 seconds 10 times for a total of 2 sets. Immediate changes in range of motion and pain were identified. Results: Following skin mobilization, there was an immediate increase in range of motion (pre 116°, post 140°) and a decrease in pain (NRS pre 5, post 2). And also uncomfortable pain, which is hard to define in words, also seems to have improved. Conclusions: Skin mobilization, which considers skin mobility for patients with Axillary web syndrome, can be considered for improving range of motion and restoring function in patients with pain due to fibrous bands around veins and lymphatic vessels, and is recommended as a new intervention method not used as a conventional treatment.

유방절제술 환자의 불확실성, 불안 및 대처방식 (Uncertainty, Anxiety and Coping with Mastectomy for Breast Cancer)

  • 조옥희
    • 대한간호학회지
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    • 제30권4호
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    • pp.1006-1017
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    • 2000
  • The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows : 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7∼12 months(1 yr.) post operation period had higher than the one below 6months, 25∼36 months(3 yrs.), 37∼60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7∼12 months(1 yr.) post operation period, but there was no significant difference by general characteristics 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25∼36 months of post operation period showed significantly lower level of coping than those below 6 months or 37∼60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

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What Made Her Give Up Her Breasts: a Qualitative Study on Decisional Considerations for Contralateral Prophylactic Mastectomy among Breast Cancer Survivors Undergoing BRCA1/2 Genetic Testing

  • Kwong, Ava;Chu, Annie T.W.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2241-2247
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    • 2012
  • Objective: This qualitative study retrospectively examined the experience and psychological impact of contralateral prophylactic mastectomy (CPM) among Southern Chinese females with unilateral breast cancer history who underwent BRCA1/2 genetic testing. Limited knowledge is available on this topic especially among Asians; therefore, the aim of this study was to acquire insight from Chinese females' subjective perspectives. Methods: A total of 12 semi-structured in-depth interviews, with 11 female BRCA1/BRCA 2 mutated gene carriers and 1 non-carrier with a history of one-sided breast cancer and genetic testing performed by the Hong Kong Hereditary Breast Cancer Family Registry, who subsequently underwent CPM, were assessed using thematic analysis and a Stage Conceptual Model. Breast cancer history, procedures conducted, cosmetic satisfaction, pain, body image and sexuality issues, and cancer risk perception were discussed. Retrieval of medical records using a prospective database was also performed. Results: All participants opted for prophylaxis due to their reservations concerning the efficacy of surveillance and worries of recurrent breast cancer risk. Most participants were satisfied with the overall results and their decision. One-fourth expressed different extents of regrets. Psychological relief and decreased breast cancer risk were stated as major benefits. Spouses' reactions and support were crucial for post-surgery sexual satisfaction and long-term adjustment. Conclusions: Our findings indicate that thorough education on cancer risk and realistic expectations of surgery outcomes are crucial for positive adjustment after CPM. Appropriate genetic counseling and pre-and post-surgery psychological counseling were necessary. This study adds valuable contextual insights into the experiences of living with breast cancer fear and the importance of involving spouses when counseling these patients.