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      Implementación de un modelo de atención kinesiológico, temprano y prospectivo, en personas con cáncer de mama Translated title: Implementation of an early and prospective physical therapy model care in people with breast cancer

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          Abstract

          Resumen El cáncer de mama es un problema de salud pública en Chile y el mundo por su alta incidencia. La cirugía es un pilar fundamental en el tratamiento del cáncer de mama. Hasta un 60% de las personas tratadas por cáncer de mama presentan alteraciones funcionales en el miembro superior. Existen modelos sanitarios para la rehabilitación de las alteraciones funcionales, sin embargo, en Chile no es un estándar en la atención de salud. Este artículo describe: 1) las alteraciones del miembro superior secundarias a la cirugía por cáncer de mama y 2) un modelo de atención kinesiológico, temprano y prospectivo, para personas tratadas por cáncer de mama.

          Translated abstract

          Breast cancer is a public health problem in Chile and the world due to high incidence. Surgery is the mainstay in the breast cancer treatment. Up to 60% of people receiving this management have functional morbidity in the upper limb. There are rehabilitation health models care for the functional morbidity, however, in Chile is not a standard in the health care. This article describes: 1) upper limb morbidity secondary to breast cancer surgery, and 2) early and prospective physical Therapy model care for people with breast cancer.

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          A prospective surveillance model for rehabilitation for women with breast cancer.

          The current model of care for individuals with breast cancer focuses on treatment of the disease, followed by ongoing surveillance to detect recurrence. This approach lacks attention to patients' physical and functional well-being. Breast cancer treatment sequelae can lead to physical impairments and functional limitations. Common impairments include pain, fatigue, upper-extremity dysfunction, lymphedema, weakness, joint arthralgia, neuropathy, weight gain, cardiovascular effects, and osteoporosis. Evidence supports prospective surveillance for early identification and treatment as a means to prevent or mitigate many of these concerns. This article proposes a prospective surveillance model for physical rehabilitation and exercise that can be integrated with disease treatment to create a more comprehensive approach to survivorship health care. The goals of the model are to promote surveillance for common physical impairments and functional limitations associated with breast cancer treatment; to provide education to facilitate early identification of impairments; to introduce rehabilitation and exercise intervention when physical impairments are identified; and to promote and support physical activity and exercise behaviors through the trajectory of disease treatment and survivorship.
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            Treatment Related Impairments in Arm and Shoulder in Patients with Breast Cancer: A Systematic Review

            Background Breast cancer is the most common type of cancer in women in the developed world. As a result of breast cancer treatment, many patients suffer from serious complaints in their arm and shoulder, leading to limitations in activities of daily living and participation. In this systematic literature review we present an overview of the adverse effects of the integrated breast cancer treatment related to impairment in functions and structures in the upper extremity and upper body and limitations in daily activities. Patients at highest risk were defined. Methods and Findings We conducted a systematic literature search using the databases of PubMed, Embase, CINAHL and Cochrane from 2000 to October 2012, according to the PRISMA guidelines. Included were studies with patients with stage I–III breast cancer, treated with surgery and additional treatments (radiotherapy, chemotherapy and hormonal therapy). The following health outcomes were extracted: reduced joint mobility, reduced muscle strength, pain, lymphedema and limitations in daily activities. Outcomes were divided in within the first 12 months and >12 months post-operatively. Patients treated with ALND are at the highest risk of developing impairments of the arm and shoulder. Reduced ROM and muscle strength, pain, lymphedema and decreased degree of activities in daily living were reported most frequently in relation to ALND. Lumpectomy was related to a decline in the level of activities of daily living. Radiotherapy and hormonal therapy were the main risk factors for pain. Conclusions Patients treated with ALND require special attention to detect and consequently address impairments in the arm and shoulder. Patients with pain should be monitored carefully, because pain limits the degree of daily activities. Future research has to describe a complete overview of the medical treatment and analyze outcome in relation to the treatment. Utilization of uniform validated measurement instruments has to be encouraged.
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              Why have breast cancer mortality rates declined?

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                revistacirugia
                Revista de cirugía
                Rev. cir.
                Sociedad de Cirujanos de Chile (Santiago, , Chile )
                2452-4557
                2452-4549
                October 2019
                : 71
                : 5
                : 476-481
                Affiliations
                [1] Santiago Santiago de Chile orgnamePontificia Universidad Católica de Chile orgdiv1Facultad de Medicina orgdiv2Departamento de Ciencias de la Salud Chile
                [2] Santiago orgnameComplejo Asistencial Dr. Sótero del Río Chile
                [3] Concepción Bío-Bío orgnameUniversidad Católica de la Santísima Concepción orgdiv1Facultad de Medicina orgdiv2Departamento de Salud Pública Chile
                Article
                S2452-45492019000500476
                10.35687/s2452-45492019005607
                9d8fd183-807e-43d0-ac53-f489cecde14d

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 18 July 2019
                : 30 July 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 6
                Product

                SciELO Chile

                Categories
                Cirugía al Día

                physical therapy,upper limb,breast neoplasm,functionality morbidity,neoplasia de mama,terapia física,rehabilitación,miembro superior,alteraciones funcionales,rehabilitation

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