Abstract
Background: The most commonly identified cancer is breast cancer. In either the lobules or the breast ducts, the cancer normally grows. Infiltrating ductal carcinoma is the most common subtype. It may appear as a lump or mass; changes in the skin or nipple; breast rash or redness; or lymphadenopathy.
 Presenting Complains and Investigations: the patient presented with the complains of swelling and pain in the left breast in lower outer quadrant since 6 months, which was initially small in size and gradually increased and reached up this level 2x2 cm which placed in infra areolar region covering lower inner and outer quadrant. USG and cytology reports showed bilateral breast with axilla. Right breast was normal, enlarged lymph node in the right axilla measuring 15.2 x 4.6 mm with maintained hilum S/O reactive lymphadenopathy. In left breast there is E/O ill-defined taller than wider irregular hypoechoic lesion with spiculated margins, measuring approximately 15.9 x 12.4 mm in lower inner quadrant containing multiple foci of calcification within showing central vascularity OB doppler on elastography lesion is stiff, in left axilla there is E/O on enlarged USG lymph node present measuring 10.2 x 6.7 mm with maintained hilum S/O reactive lymphadenopathy. Impression of F/S/O malignant lesion in the left breast lymphadenopathy.
 Diagnosis: Left sided infiltrating ductal carcinoma.
 Therapeutic Intervention and Outcomes: Physical therapy intervention involved a variety of range of motion exercises, strengthening exercises, resistance conditioning, breathing exercises, lymphoedema treatment and scar management. This intensive outpatient program is a successful way to enhance the mobility of the shoulder and ROM during the initial 6-week treatment cycle after surgery. Shoulder range of motion was increased, patient was able to do basic activities of daily living like dressing, bathing, combing, etc. Edema was reduced.
 Conclusion: Shoulder stiffness after modified radical mastectomy is the commonest complication. Upper limb mobility exercises reduced the shoulder stiffness. Breathing exercises improved the respiration. Strengthening and general aerobic exercises helped the patient to get back on her normal routine.
Highlights
Breast cancer is the most frequently diagnosed female cancer and ranks second among the cancer causes of death in women [1]
In either the lobules or the breast ducts, the cancer normally grows [3].In situ, ductal carcinoma is the most common subtype (DCIS). This type of cancer initiates and invades fatty tissues inside the breast. It may appear as a lump or mass; changes in the skin or nipple; breast rash or redness; or lymphadenopathy [4].With the rise in age at first birth, the incidence of breast cancer increased; this impact was not compensated for by parity
This case involves a 28 years old female, resident of Deoli village, Wardha district, presented with complains of swelling and pain in the left breast in lower outer quadrant since 6 months, which was initially small in size and gradually increased and reached up this level 2x2 cm which placed in infra areolar region covering lower inner and outer quadrant
Summary
Breast cancer is the most frequently diagnosed female cancer and ranks second among the cancer causes of death in women [1]. This type of cancer initiates and invades fatty tissues inside the breast. It may appear as a lump or mass; changes in the skin or nipple; breast rash or redness; or lymphadenopathy [4].With the rise in age at first birth, the incidence of breast cancer increased; this impact was not compensated for by parity. Age at first birth tended to reduce the risk as opposed to no pregnancy, while late age at first birth was linked with a higher risk than not getting full-term pregnancy. In comparison to non-pregnancy, early age at first birth tended to decrease the risk, whereas late age at first birth was associated with a higher risk than fullterm pregnancy. The incidence of breast cancer is higher, while the relative mortality is highest in less developed countries [6]
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