The multidisciplinary approach to breast cancer – the role of support specialties before and after mastectomy

Abstract

Introduction. Although many patients recover functionally, breast cancer and mastectomy have physical and psycho-emotional impact on the quality of life. To avoid errors and biases, reduce emotional distress and help postoperative recovery, physiotherapeutic and psychological assessments before and after mastectomy are needed. The objective of the study was to demonstrate that physiotherapy and psychological counseling enhance the rehabilitation process, by assessing and treating the postural alterations and lymphedema and reducing the level of distress and anxiety. Material and methods. We performed a prospective study on 20 patients with breast cancer, aged 32-65 years, divided into two equal groups. The study group undergone physiotherapeutic and psychological assessment and intervention, before mastectomy (for postural alterations, emotional status) and after mastectomy (for lymphedema, limited arm movements, anxiety, depression, hopelessness, acceptance). None of the patients in the control group presented to physiotherapeutic and psychological assessment before mastectomy. After surgery, all were assessed by a physiotherapist, 2 patients completed the therapy; 70% went to psychological evaluation, but had poor attendance to counseling sessions. Results. Six patients had postural and biomechanical changes and variable degrees of psychological distress, prior to mastectomy. The compliance to physiotherapeutic rehabilitation was greater in the study group than in the control group. The levels of distress were lower in the study group, due to pre-surgery counseling sessions. Conclusions. The data confirmed the utility of preoperative assessments and counseling, the need for post mastectomy interventions and support the efficiency of the multidisciplinary approach of breast cancer cases.

Keywords

• physiotherapy
• psychological assessment
• counseling
• compensation
• distress