Meme Kanseri Cerrahisi Sonrası Ekstremite Hacmi ile Ağrı, Duyu ve Kavrama Kuvveti Arasındaki İlişki
Yıl 2022,
Cilt: 7 Sayı: 1, 49 - 54, 31.01.2022
Sevtap Günay Uçurum
,
Karya Polat
,
İlknur Naz Gürşan
,
Korhan Barış Bayram
,
Derya Özer Kaya
Öz
Amaç: Üst ekstremite hacmindeki artış meme kanseri cerrahisi sonrasında görülen en yaygın komplikasyonlardan biridir ve üst ekstremite fonksiyonlarını olumsuz etkileyebilmektedir. Bu çalışmanın amacı meme kanseri cerrahisi sonrası, üst ekstremite hacmi ile ağrı, duyu ve kavrama kuvveti arasındaki ilişkileri araştırmaktı.
Gereç ve Yöntem: Çalışmaya 44-73 (54,00/50,50-62,00 yıl) yaş arası, meme kanseri tanısı sonrası cerrahi ve onkolojik tedavi almış ve son tedavisini en az üç ay önce tamamlamış 49 katılımcı dahil edildi. Üst ekstremite hacmi Frustum yöntemi ile hesaplandı, ağrı Görsel Analog Skala ile sorgulandı, duyu Semmes-Weinstein Monofilament Testi ile değerlendirildi ve kavrama kuvveti hand-held dinamometre ile ölçüldü.
Bulgular: Etkilenen ekstremitede, etkilenmeyen ekstremiteye göre kavrama kuvveti daha düşük (p<0,001) ve ekstremite hacmi daha yüksekti (p<0,001). Üst ekstremite hacmi ile birinci parmak ucunda duyu kaybı arasında (p=0,036) ve üst ekstremite hacmi ile hipotenar bölge duyu kaybı arasında (p=0,036) pozitif yönde düşük orta derecede ilişkiler tespit edildi.
Sonuç: Bu çalışmanın sonuçlarına göre meme kanseri cerrahisi sonrası üst ekstremite hacmindeki artış üst ekstremite duyusu ile ilişkili, bununla birlikte, ağrı veya kas kuvveti ile ilişkili değildir. Meme kanseri cerrahisi sonrasında sıklıkla görülen üst ekstremite hacmindeki değişikliklerin ilişkili olduğu faktörler önleme ve tedavi sürecine yön verme açısından akılda tutulmalıdır.
Destekleyen Kurum
İzmir Katip Çelebi Üniversitesi Bilimsel Araştırmalar Projeleri Koordinatörlüğü
Proje Numarası
2018-GAP-SABF-0007
Teşekkür
Bu araştırma, İzmir Katip Çelebi Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğünce, ''2018-GAP-SABF-0007'' nolu '' Tedavisi tamamlanmış meme kanserli hastalarda postural stabilite ve ilişkili faktörlerin araştırılması'' isimli yönlendirilmiş alt yapı projesi ile desteklenmiştir.
Kaynakça
- Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 01 Mart 2015;136(5):E359-386.
- Ekim Ayı Meme Kanseri Farkındalık Ayı [İnternet]. [a.yer 08 Kasım 2021]. Erişim adresi: https://hsgm.saglik.gov.tr/tr/kanser-haber/ekimayi- meme-kanseri-farkindalik-ayi-3.html
- DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and metaanalysis. Lancet Oncol. Mayıs 2013;14(6):500-15.
- Soyder A, Taştaban E, Özbaş S, Boylu Ş, Özgün H. Frequency of earlystage lymphedema and risk factors in postoperative patients with breast cancer. J Breast Health. 01 Nisan 2014;10(2):92-7.
- Moffatt CJ, Franks PJ, Doherty DC, Williams AF, Badger C, Jeffs E, et al. Lymphoedema: an underestimated health problem. QJM. Ekim 2003;96(10):731-8.
- Passik SD, McDonald MV. Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer. 15 Aralık 1998;83(12 Suppl American):2817-20.
- Pyszel A, Malyszczak K, Pyszel K, Andrzejak R, Szuba A. Disability, psychological distress and quality of life in breast cancer survivors with arm lymphedema. Lymphology. Aralık 2006;39(4):185-92.
- Martín ML, Hernández MA, Avendaño C, Rodríguez F, Martínez H. Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema. BMC Cancer. 09 Mart 2011;11:94.
- Smoot B, Wong J, Cooper B, Wanek L, Topp K, Byl N, et al. Upper extremity impairments in women with or without lymphedema following breast cancer treatment. J Cancer Surviv. Haziran 2010;4(2):167-78.
- Teo I, Novy DM, Chang DW, Cox MG, Fingeret MC. Examining pain, body image, and depressive symptoms in patients with lymphedema secondary to breast cancer. Psychooncology. Kasım 2015;24(11):1377- 83.
- Korucu TS, Ucurum SG, Tastaban E, Ozgun H, Kaya DO. Comparison of shoulder-arm complex pain, function, and scapular dyskinesia in women with and without unilateral lymphedema after breast cancer surgery. Clin Breast Cancer. Haziran 2021;21(3):e285-93.
- Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol. 20 Temmuz 2008;26(21):3536-42.
- Hayes SC, Reul-Hirche H, Turner J. Exercise and secondary lymphedema: safety, potential benefits, and research issues. Med Sci Sports Exerc. Mart 2009;41(3):483-9.
- Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. Eylül 1983;17(1):45-56.
- Bell-Krotoski JA, Fess EE, Figarola JH, Hiltz D. Threshold detection and Semmes-Weinstein monofilaments. J Hand Ther. Haziran 1995;8(2):155- 62.
- Bohannon RW. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. Ocak 1997;78(1):26-32.
- Kaulesar Sukul DM, den Hoed PT, Johannes EJ, van Dolder R, Benda E. Direct and indirect methods for the quantification of leg volume: comparison between water displacement volumetry, the disk model method and the frustum sign model method, using the correlation coefficient and the limits of agreement. J Biomed Eng. Kasım 1993;15(6):477-80.
- Mobarakeh ZS, Mokhtari-Hesari P, Lotfi-Tokaldany M, Montazeri A, Heidari M, Zekri F. Combined decongestive therapy and reduction of pain and heaviness in patients with breast cancer-related lymphedema. Support Care Cancer. Ekim 2019;27(10):3805-11.
- Mafu TS, September AV, Shamley D. The potential role of angiogenesis in the development of shoulder pain, shoulder dysfunction, and lymphedema after breast cancer treatment. Cancer Manag Res. 2018;10:81-90.
- Baran E, Özçakar L, Özgül S, Aksoy S, Akbayrak T. Upper limb sensory evaluations and ultrasonographic skin measurements in breast cancer– related lymphedema receiving complex decongestive physiotherapy. Support Care Cancer. 01 Kasım 2021;29(11):6545-53.
- Karadibak D, Yavuzsen T. Evaluation of kinesthetic sense and hand function in women with breast cancer-related lymphedema. J Phys Ther Sci. Haziran 2015;27(6):1671-5.
- Dawes DJ, Meterissian S, Goldberg M, Mayo NE. Impact of lymphoedema on arm function and health-related quality of life in women following breast cancer surgery. J Rehabil Med. Ağustos 2008;40(8):651-8.
- Mistry S, Ali T, Qasheesh M, Beg RA, Shaphe MA, Ahmad F, et al. Assessment of hand function in women with lymphadenopathy after radical mastectomy. PeerJ. 2021;9:e11252.
- Koca TT, Aktaş G, Kurtgil ME. Prevelance of upper extremity lymphedema and risk factors in patients with mastectomy: Singlecenter, observational, cross-sectional study. Turk J Obstet Gynecol. Eylül 2020;17(3):215-24.
- Ci̇velek G. Meme kanseri ile ilişkili lenfödemin el kas gücü, el fonksiyonları ve elde duyu kaybına etkisi. Cukurova Medical Journal. 30 Haziran 2016;41(2):208-16.
- Torresan RZ, Cabello C, Conde DM, Brenelli HB. Impact of the preservation of the intercostobrachial nerve in axillary lymphadenectomy due to breast cancer. Breast J. Ekim 2003;9(5):389- 92.
- Strzalkowski NDJ, Triano JJ, Lam CK, Templeton CA, Bent LR. Thresholds of skin sensitivity are partially influenced by mechanical properties of the skin on the foot sole. Physiological Reports. 2015;3(6):e12425.
- Themes UFO. Edema Reduction Techniques: A Biologic Rationale for Selection [Internet]. Musculoskeletal Key. 2016 [a.yer 14 Kasım 2021]. Erişim adresi: https://musculoskeletalkey.com/edema-reductiontechniques- a-biologic-rationale-for-selection/
- Keser I, Esmer M. Does manual lymphatic drainage have any effect on pain threshold and tolerance of different body parts? Lymphat Res Biol. Aralık 2019;17(6):651-4.
The Relationship between Extremity Volume with Pain, Sensation and Grip Strength After Breast Cancer Surgery
Yıl 2022,
Cilt: 7 Sayı: 1, 49 - 54, 31.01.2022
Sevtap Günay Uçurum
,
Karya Polat
,
İlknur Naz Gürşan
,
Korhan Barış Bayram
,
Derya Özer Kaya
Öz
Objective: The increase in the upper extremity volume is one of the most common complications following breast cancer surgery and it may affect upper extremity functions negatively. The purpose of the present study was to investigate the relationships among upper extremity volume and pain, sensation, and grip strength following breast cancer surgery.
Material and Method: Forty-nine participants who were between 44-73 (54.00/50.50-62.00) years, who had received surgical and oncological treatment following the breast cancer diagnosis, and who had completed their last treatment at least three months ago were included in the study. The upper extremity volume was calculated by using the Frustum method, pain was inquired with Visual Analog Scale, sensation was evaluated with the Semmes-Weinstein Monofilament Test, and grip strength was measured with a hand-held dynamometer.
Results: The grip strength was poorer (p<0.001), and the extremity volume was higher (p<0. 001) in the affected extremity compared to the unaffected extremity. Positive low-moderate relationships were detected between upper extremity volume and loss of sensation in the first fingertip (p=0.036), and between upper extremity volume and loss of sensation in the hypothenar (p=0.036) region.
Conclusion: According to results of the present study, the increase in the upper extremity volume following breast cancer surgery is related to upper extremity sensation, however, is not related to pain or muscle strength. The factors associated to changes in the upper extremity volume, which are frequently seen following breast cancer surgery, should be considered for guiding the prevention and treatment processes.
Proje Numarası
2018-GAP-SABF-0007
Kaynakça
- Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 01 Mart 2015;136(5):E359-386.
- Ekim Ayı Meme Kanseri Farkındalık Ayı [İnternet]. [a.yer 08 Kasım 2021]. Erişim adresi: https://hsgm.saglik.gov.tr/tr/kanser-haber/ekimayi- meme-kanseri-farkindalik-ayi-3.html
- DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and metaanalysis. Lancet Oncol. Mayıs 2013;14(6):500-15.
- Soyder A, Taştaban E, Özbaş S, Boylu Ş, Özgün H. Frequency of earlystage lymphedema and risk factors in postoperative patients with breast cancer. J Breast Health. 01 Nisan 2014;10(2):92-7.
- Moffatt CJ, Franks PJ, Doherty DC, Williams AF, Badger C, Jeffs E, et al. Lymphoedema: an underestimated health problem. QJM. Ekim 2003;96(10):731-8.
- Passik SD, McDonald MV. Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer. 15 Aralık 1998;83(12 Suppl American):2817-20.
- Pyszel A, Malyszczak K, Pyszel K, Andrzejak R, Szuba A. Disability, psychological distress and quality of life in breast cancer survivors with arm lymphedema. Lymphology. Aralık 2006;39(4):185-92.
- Martín ML, Hernández MA, Avendaño C, Rodríguez F, Martínez H. Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema. BMC Cancer. 09 Mart 2011;11:94.
- Smoot B, Wong J, Cooper B, Wanek L, Topp K, Byl N, et al. Upper extremity impairments in women with or without lymphedema following breast cancer treatment. J Cancer Surviv. Haziran 2010;4(2):167-78.
- Teo I, Novy DM, Chang DW, Cox MG, Fingeret MC. Examining pain, body image, and depressive symptoms in patients with lymphedema secondary to breast cancer. Psychooncology. Kasım 2015;24(11):1377- 83.
- Korucu TS, Ucurum SG, Tastaban E, Ozgun H, Kaya DO. Comparison of shoulder-arm complex pain, function, and scapular dyskinesia in women with and without unilateral lymphedema after breast cancer surgery. Clin Breast Cancer. Haziran 2021;21(3):e285-93.
- Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol. 20 Temmuz 2008;26(21):3536-42.
- Hayes SC, Reul-Hirche H, Turner J. Exercise and secondary lymphedema: safety, potential benefits, and research issues. Med Sci Sports Exerc. Mart 2009;41(3):483-9.
- Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. Eylül 1983;17(1):45-56.
- Bell-Krotoski JA, Fess EE, Figarola JH, Hiltz D. Threshold detection and Semmes-Weinstein monofilaments. J Hand Ther. Haziran 1995;8(2):155- 62.
- Bohannon RW. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. Ocak 1997;78(1):26-32.
- Kaulesar Sukul DM, den Hoed PT, Johannes EJ, van Dolder R, Benda E. Direct and indirect methods for the quantification of leg volume: comparison between water displacement volumetry, the disk model method and the frustum sign model method, using the correlation coefficient and the limits of agreement. J Biomed Eng. Kasım 1993;15(6):477-80.
- Mobarakeh ZS, Mokhtari-Hesari P, Lotfi-Tokaldany M, Montazeri A, Heidari M, Zekri F. Combined decongestive therapy and reduction of pain and heaviness in patients with breast cancer-related lymphedema. Support Care Cancer. Ekim 2019;27(10):3805-11.
- Mafu TS, September AV, Shamley D. The potential role of angiogenesis in the development of shoulder pain, shoulder dysfunction, and lymphedema after breast cancer treatment. Cancer Manag Res. 2018;10:81-90.
- Baran E, Özçakar L, Özgül S, Aksoy S, Akbayrak T. Upper limb sensory evaluations and ultrasonographic skin measurements in breast cancer– related lymphedema receiving complex decongestive physiotherapy. Support Care Cancer. 01 Kasım 2021;29(11):6545-53.
- Karadibak D, Yavuzsen T. Evaluation of kinesthetic sense and hand function in women with breast cancer-related lymphedema. J Phys Ther Sci. Haziran 2015;27(6):1671-5.
- Dawes DJ, Meterissian S, Goldberg M, Mayo NE. Impact of lymphoedema on arm function and health-related quality of life in women following breast cancer surgery. J Rehabil Med. Ağustos 2008;40(8):651-8.
- Mistry S, Ali T, Qasheesh M, Beg RA, Shaphe MA, Ahmad F, et al. Assessment of hand function in women with lymphadenopathy after radical mastectomy. PeerJ. 2021;9:e11252.
- Koca TT, Aktaş G, Kurtgil ME. Prevelance of upper extremity lymphedema and risk factors in patients with mastectomy: Singlecenter, observational, cross-sectional study. Turk J Obstet Gynecol. Eylül 2020;17(3):215-24.
- Ci̇velek G. Meme kanseri ile ilişkili lenfödemin el kas gücü, el fonksiyonları ve elde duyu kaybına etkisi. Cukurova Medical Journal. 30 Haziran 2016;41(2):208-16.
- Torresan RZ, Cabello C, Conde DM, Brenelli HB. Impact of the preservation of the intercostobrachial nerve in axillary lymphadenectomy due to breast cancer. Breast J. Ekim 2003;9(5):389- 92.
- Strzalkowski NDJ, Triano JJ, Lam CK, Templeton CA, Bent LR. Thresholds of skin sensitivity are partially influenced by mechanical properties of the skin on the foot sole. Physiological Reports. 2015;3(6):e12425.
- Themes UFO. Edema Reduction Techniques: A Biologic Rationale for Selection [Internet]. Musculoskeletal Key. 2016 [a.yer 14 Kasım 2021]. Erişim adresi: https://musculoskeletalkey.com/edema-reductiontechniques- a-biologic-rationale-for-selection/
- Keser I, Esmer M. Does manual lymphatic drainage have any effect on pain threshold and tolerance of different body parts? Lymphat Res Biol. Aralık 2019;17(6):651-4.