Postmastectomy Patients Research Articles

Ergonomic design of mastectomy bra based on emotion measurements

The mastectomy bra (M-bra) serves as an essential rehabilitative product for individuals who have undergone breast cancer surgery. This study aimed to develop an ergonomic design method for M-bras that addresses both the physiological and psychological needs of post-mastectomy breast cancer patients. Over 270 M-bras with diverse design options were collected from online markets, and more than 100 post-mastectomy patients participated in an online survey to rank their preferences regarding eight M-bra components and 19 design options. An orthogonal experimental design was applied to reduce the vast array of design combinations to 20 M-bra test samples. The Pleasure-Arousal-Dominance (PAD) emotion model and the Self-Assessment Manikin (SAM) scale were then used to collect PAD scores from 40 patients evaluating these test samples. Extreme difference analysis was conducted to evaluate the significance of the M-bra components and identify combinations that generated the highest and lowest PAD levels. Based on the PAD scores, 11 samples were categorized as "delighted" or "relaxed" M-bras due to their positive emotional polarity. Linear regression analysis showed strong correlations between the design options and PAD scores, with R2 values of 0.962 for P, 0.819 for A, and 0.949 for D. A backpropagation neural network was developed to predict PAD values for various M-bra design options, achieving prediction errors of 8.06% for P, 6.15% for A, and 13.29% for D, demonstrating satisfactory performance given the subjective nature of the evaluations.

Radiation-Induced Hypothyroidism in Post-Mastectomy Patients: A Prospective Cohort Study

Purpose: Our study aims to assess the incidence of radiotherapy-induced hypothyroidism in breast cancer patients and correlate it with the mean dose to the thyroid. Method: Out of 75 patients, who were treated under 3-dimensional conformal radiotherapy field in field {3D CRT(FiF)} by conventional Radiotherapy to post-modified radical mastectomy (MRM) chest wall, a dosing regimen of 200cGy per fraction for a total 5000cGy at our center in the year 2016, 63 patients were randomized and investigated. All patients were treated by Linear accelerator, varian, with the Eclipse version 13.6 treatment planning system. All information on radiotherapy used for each patient was extracted from the Eclipse treatment planning system. All patients were followed up for 7 years after Radiotherapy. TSH and freeT4 levels were measured. The Chi-square test was used to compare the outcome of the disease in terms of nominal and rank qualitative variables. Student t-test was used to compare in terms of quantitative variables. Result: After 7 years since the radiotherapy, according to the results, a total of 10 out of 63, {15.87% (P = 0.008)} of patients had hypothyroidism, of which 11.11% (7 out of 63) were clinical, and 4.76% (3 out of 63) were subclinical. Dmean > 21 Gy compared with Dmean ≤ 21 Gy was associated with a significantly higher incidence of radiation-induced hypothyroidism (RHT) at 7 years after radiotherapy (3.17% vs. 12.7%, P<0.001). Conclusion: We recommend that the Dmean of the thyroid should be kept lower than 21Gy for post-modified radical mastectomy radiotherapy to decrease the incidence of radiation-induced hypothyroidism. Further investigations in larger cohorts are required to confirm our results.

Mind the gap: treating post-surgical scar tissue in post-mastectomy patients – a randomized clinical trial

IntroductionPost-mastectomy physiotherapy typically includes massage, exercise, and stretching, but often fails to treat post-surgical scar tissue, a significant contributor to long-term disability. This study aimed to compare conventional therapy with myofascial manual therapy for treating post-surgical scar tissue in post-mastectomy patients and to determine the effectiveness of these treatments.MethodsThe study was an experimental controlled study with pre- and post-testing of two parallel groups. Forty-eight women experiencing shoulder and/or upper torso impairment following mastectomy were randomly allocated to either a control group (<i>n</i> = 21) or a myofascial therapy group (<i>n</i> = 27). Conventional physiotherapy involving exercise and massage or myofascial therapy was used. Pre- and post-therapy measurements included muscle length, pain intensity, range of motion (ROM), and scar mobility.ResultsMyofascial therapy was superior to conventional physiotherapy in reducing the percentage of patients with below-normal muscle lengths at several sites. Significant decreases from baseline were observed in the treatment group for the pars clavicularis, descending trapezius, pars sternocostalis, latissimus dorsi, and levator scapulae muscles. Myofascial therapy also improved mobility in the scar area, with increases of 3 mm relative to the xiphoid process and 4 mm relative to the coracoid.ConclusionsOur study indicates that myofascial interventions improve upper limb ROM and muscle elasticity in the upper limb girdle of post-mastectomy patients. These findings provide empirical evidence supporting the benefits of myofascial intervention over conventional physiotherapy in the treatment of post-surgical scar tissue in this patient group.

Physiotherapeutic Assessment in Oncological Post-Mastectomy Patients

Introduction: Breast cancer is one of the most prevalent forms of cancer among women, and the medical treatment protocols are highly aggressive. In the case of mastectomy, a number of different sequelae are generated, including pain, functional limitation of the shoulder, dehiscence of the wound, decrease in joint range, decrease in muscle strength, lymphedema, and so forth. Such consequences directly impact the functionality and quality of life of the individual. Physiotherapy represents a potential avenue for addressing the sequelae resulting from the surgical procedure. Objective: The objective is to conduct a bibliographic research on the early physiotherapeutic treatment of post-mastectomy cancer patients. Methodology: A search for clinical trials from 2016 to 2023 was conducted in multiple languages, including English, Portuguese, and Spanish, across several databases: PEDro, PubMed, ScienceDirect, Cochrane, and Google Scholar. The inclusion and exclusion criteria facilitated an appropriate selection process for clinical trials, in conjunction with the PRISMA method. The selected clinical trials included a total sample of 644 individuals, in which various physiotherapeutic modalities were evaluated for the purpose of combating the various sequelae generated by mastectomy. Conclusions: Physiotherapy offers a range of beneficial therapeutic modalities, which, when applied early in post-mastectomy cancer patients, have a positive impact on these individuals. These include therapeutic exercise, hydrotherapy, and resistance aerobic exercise. Conversely, there are modalities such as manual lymphatic drainage and extracorporeal shock wave therapy that have uncertain benefits, given the lack of consensus on their evidence base.

Unveiling perceptions regarding post mastectomy breast reconstruction: A questionnaire-based survey of patients from central India.

Post mastectomy breast reconstruction uptake remains low in the developing countries. We examined patient perspectives about it in a cohort of Indian breast cancer patients. This prospective study was conducted at a tertiary care center in central India. All post mastectomy patients for breast cancer were interviewed via a survey questionnaire to assess their perspective regarding post mastectomy breast reconstruction. None of the 192 patients underwent immediate or delayed reconstruction by the end of 24months follow-up. Age, education level, occupation and marital status did not affect the uptake of post mastectomy breast reconstruction. The most common patient-reported reasons for not having reconstruction were the desire to avoid additional surgery and the belief that it was not important (80% for each). System related factors such as additional cost of surgery and additional length of stay were reported to be important by 55% and 65% patients respectively. Our survey of 192 post mastectomy breast cancer patients showed that none opted for post mastectomy reconstruction, suggesting significant barriers to it. Understanding and addressing these barriers are crucial to ensuring comprehensive care for these breast cancer patients.

Perceived social support mediates cancer and living meaningfully intervention effects on quality of life after breast cancer surgery.

Aim: To explore the role of perceived social support in enhancing psychological resilience and quality of life in postoperative breast cancer patients.Materials & methods: The Managing Cancer and Living Meaningfully (CALM) intervention was used to improve indicators such as psychological resilience in breast cancer patients, while the role of perceived social support in this was assessed.Results: The intervention group exhibited significant improvements compared with the control group in psychological resilience (F=9.059, p<0.01). The analysis showed that increased social support in the control group partly mediated the link between psychological resilience and quality of life.Conclusion: CALM improves overall well-being, indicating that incorporating it into standard care for post-mastectomy patients can positively impact their mental health.

Beyond Mastectomy: The Incidence of Subsequent Aesthetic Procedures after Mastectomy with and without Breast Reconstruction.

Mastectomy poses significant challenges to a woman's body image and psychological well-being, and breast reconstruction plays a pivotal role in postoperative quality of life. Following breast reconstruction, many patients choose to have subsequent aesthetic procedures. Data on the prevalence of such subsequent aesthetic interventions are lacking in the literature. The aim of this study was to analyze trends in aesthetic procedures in patients following mastectomy with and without breast reconstruction. The PearlDiver database was queried within its capabilities for patients who underwent mastectomy with and without breast reconstruction, and a variety of aesthetic procedures after mastectomy. Aesthetic procedure rates were compared between cohorts. We identified 365,525 mastectomy patients: 282,815 without reconstruction and 82,710 with reconstruction. In total, 609 patients with reconstruction and 329 without underwent subsequent aesthetic procedures. The rate of aesthetic procedures was higher in the reconstruction group (0.7%) compared with the nonreconstruction group (0.1%; P < 0.001). Patients who chose to have breast reconstruction after mastectomy underwent significantly more subsequent aesthetic procedures compared with those who chose mastectomy alone. Our findings provide insights on the prevalence of aesthetic procedures in postmastectomy patients, highlighting the potentially longitudinal nature of the reconstructive and aesthetic journey beyond the index oncologic procedure. Further research is needed to address motivations for such procedures as well as patient-reported outcomes and satisfaction.

Revitalizing Post-Mastectomy Lives: Unveiling the Impact of Aerobic and Mobility with Strengthening Exercises in Improving Shoulder Pain, ROM, and Strength

Background: Breast cancer is the most prevalent cancer among women globally, with Pakistan having one of the highest incidence rates in Asia. Post-mastectomy patients often suffer from shoulder pain, reduced range of motion (ROM), and muscle weakness, impacting their quality of life. This study investigates the efficacy of a comprehensive exercise regimen in alleviating these symptoms. Objective: To evaluate the impact of aerobic, mobility, and strengthening exercises on shoulder pain, ROM, and muscle strength in post-mastectomy patients undergoing chemotherapy. Methods: A six-month case-control study was conducted with 60 participants, aged 25-65, who had undergone radical mastectomy and were in the chemotherapy phase. Participants were randomly assigned to two groups: the case group (n=30), which underwent an eight-week program of aerobic, mobility, and strengthening exercises, and the control group (n=30), which performed only aerobic exercises. Data collection tools included the Visual Analogue Scale (VAS) for pain assessment, a Goniometer for ROM measurement, and Manual Muscle Testing (MMT) for muscle strength evaluation. Data analysis was conducted using SPSS version 25, with paired and independent t-tests applied to compare pre- and post-intervention scores. Results: The case group showed a significant reduction in VAS scores (mean difference = 2.93333, p&lt;0.001) compared to the control group (mean difference = 0.40000, p=0.028). MMT results indicated significant improvements in muscle strength for the right deltoid (mean difference = -0.40000, p=0.009) and left pectoralis major (mean difference = -0.73333, p&lt;0.001) in the case group. ROM improvements were significant for right shoulder extension (mean difference = -0.80000, p&lt;0.001) and left shoulder external rotation (mean difference = -1.73333, p&lt;0.001) in the case group. Conclusion: A comprehensive exercise regimen, including aerobic, mobility, and strengthening exercises, significantly improved shoulder pain, ROM, and muscle strength in post-mastectomy patients. These findings support the integration of multifactorial physiotherapy into rehabilitation protocols for breast cancer survivors to enhance their long-term health and quality of life. Keywords: Breast cancer, mastectomy, shoulder pain, range of motion, muscle strength, aerobic exercises, mobility exercises, strengthening exercises, rehabilitation, physiotherapy, post-mastectomy recovery.

Effects of upper limb low resistance exercises along with manual lymphatic drainage in subjects with post radical mastectomy – a pilot study

Introduction: Post radical mastectomy patients will have physical problems like reduced shoulder movements and upper limb muscles strength. The performance and overall function of upper limb and Quality of Life (QOL) will reduce followed by these muscle’s reduced activity. The aim of present study is to find the effects of manual lymphatic drainage with low resistance training of upper limb on shoulder function and QOL of post mastectomy patients. Generally, upper limb muscles like Trapezius, serratus anterior, pectoralis s group. 1 subject from experimental group withdrawal from study. The treatment duration is 12 weeks based on cancer Rehabilitation principle. Outcome measures are taken Lymph ICF (for QOL), anatomical circumferential measurements (for Lymphedema). Patients selected based on the inclusion and exclusion criteria. Experimental group patients receiving upper limb low resistance training and manual lymphatic drainage techniques and control group patients receiving only manual lymphatic drainage techniques. Both group of patients are advised to wear upper limb elastic stockings for 8 hours per day. Result: All Outcome measures taken in baseline (pre) and end of 12 weeks (post) in both groups. Data was analysed by using paired ’t’ test. Results analysed based on pre and post test values. Conclusion: The study has designed a structured low resistance upper limb exercise program for post radical mastectomy patients in improving shoulder function and QOL.

Shoulder proprioception changesin postmastectomy patients: an observational study.

Breast cancer surgery can cause changes in the anatomical structure of the shoulder and in shoulder mobility, leading to the increased possibility of long-term arm morbidity such as lymphedema. This study aims to evaluate the active shoulder joint position sense (AJPS) with and without lymphedema in postmastectomy patients. A total of 66 women, including 22 patients with lymphedema, 22 patients without lymphedema, and 22 healthy controls, were enrolled in the study. Pain severity was evaluated with the Numeric Pain Scale and edema severity was measured with circumferentially at 10cm intervals. The normal range of motion of the shoulder joint was evaluated with the universal goniometer and the AJPS was assessed by active position repetition testing at 55°, 90°, and 125° shoulder flexion targets using the smartphone application "Clinometer." AJPS at 55°, 90°, and 125° shoulder flexion target angles with and without lymphedema were different in all target angles compared to healthy controls (p < 0.01). There was a difference between the absolute error value of AJPS at 55° flexion (p < 0.05), and no difference at 90° and 125° flexion between the with and without lymphedema groups (p > 0.05). This study shows that the AJPS was negatively affected in with and without lymphedema postmastectomy patients compared to healthy controls. This result emphasizes the importance of adding personalized methods for the restoration of joint position sense in addition to rehabilitation programs generally applied to the patient group.

Exploring post mastectomy patients’ experience on handmade knitted breast prosthesis, a project lead by the breast nurse specialist

Exploring post mastectomy patients’ experience on handmade knitted breast prosthesis, a project lead by the breast nurse specialist

Fatigue and sleep quality improvement through complete decongestive therapy in postmastectomy lymphedema: An investigative analysis

ObjectiveTo evaluate the effects of complete decongestive therapy (CDT) on cancer-related fatigue, sleep quality, and lymphedema-specific quality of life using validated and reliable questionnaires in cancer patients being commendable.Material and methodsThis prospective study includes 94 patients who had postmastectomy lymphedema syndrome. The demographic characteristics of the patients were recorded. The participants’ stages of lymphedema (The International Society of Lymphology), Hirai Cancer Fatigue Scale (HCFS) score, Pittsburgh Sleep Quality Index (PSQI) Global score, lymphedema-specific quality of life questionnaire (LYMQOL-ARM) score, and Global health status were recorded before and after CDT.ResultsThe mean age of the patients was 58.49 ± 10.96 years. Strong correlations were found between the severity of edema and global health status. There was a significant positive relationship between the HCFS score, PSQI Global score, LYMQOL-ARM score, and CDT. After decongestive physiotherapy, the majority of the lymphedema stages were downstaging (p < 0.05), respectively. There was also a trend toward improvement in general well-being (p < 0.05).ConclusionCancer-related fatigue and sleep disturbance can persist for years after surgery in women with breast cancer. This can negatively affect the patient physically, socially and cognitively. Our study, which is the first study to investigate the HCFS score in postmastectomy patients and the relationship between PSQI Global score and CDT. The findings identify the risk factors that affect these outcomes in women with lymphedema and can provide valuable insights for targeted interventions and improved patient care.

Use of Dixon in magnetic resonance breast contrast-enhanced T1 weighted high-resolution imaging for mastectomy patients at 3T: A prospective study in single center

BackgroundFor patients with complete breast resection, conventional contrast-enhanced T1-weighted imaging (CE-T1WI) with frequency-selective spectral attenuated inversion recovery (SPAIR) provides limited fat suppression on the postoperative side due to the uneven skin surface, inhomogeneous tissue environment, and frequency-selective feature of the SPAIR scheme, leading to difficulties in precise diagnosis. This study aimed to investigate the image quality and performance of the Dixon method compared with SPAIR in breast high-resolution CE-T1WI for mastectomy patients. Materials and methodsSixty female patients who had not performed any breast surgeries were randomly selected retrospectively as the control group. Postmastectomy female patients were enrolled to undergone high-resolution CE-T1WI with SPAIR and Dixon breast scans. Subjective scores were rated using a 5-point scale. Objective parameters, including contrast-to-noise ratio (CNR), edge sharpness, and signal uniformity were measured and calculated. The Wilcoxon rank-sum test and Kappa statistic were used. ResultsA total of 114 consecutive postmastectomy patients were included. Subjective scores of T1WI-SPAIR in the control group were all significantly better than those with SPAIR on the postoperative side of mastectomy patients (P < 0.01). Dixon outperformed SPAIR with significantly better subjective scores in regards to uniformity and degree of fat-suppression, anatomical structures depiction, lesion conspicuity, and axillary visibility (p < 0.05) in both post- and non-operative sides and bilateral axillary areas through the paired comparison. The objective parameters of Dixon were significantly better than those of SPAIR. ConclusionThe Dixon method provided better image uniformity and higher fat suppression efficiency, and showed significant advantages in delineating the anatomical structures, with better axillary and lesion visibilities, especially on the completely removed breast side.

Two birds one stone: lymphatic and breast reconstruction with autologous tissue

Patients with breast cancer-related lymphedema (BCRL) commonly present with both debilitating upper extremity symptoms and the need for breast reconstruction. By combining autologous flaps with physiologic lymphatic surgery, postmastectomy patients with BCRL can obtain aesthetic breast reconstruction and lymphedema management in a single operation. Lymph node transfer to an area of lymphatic obstruction creates a healthy lymphatic bridge and restores physiologic flow. Early success and improved understanding of vascularized lymph node transfer (VLNT) physiology have led to the rapid development of numerous flap options and modalities. Several studies have shown the efficacy of combining autologous breast reconstruction with VLNT. Chimeric flaps using inguinal nodes, lateral thoracic nodes, or omentum aim to construct an aesthetic breast and improve lymphatic function. In this article, we will detail the surgical options that accomplish autologous breast reconstruction and restore the lymphatic network in a single operation.

Modulation of microRNA-133B in Post Mastectomy Pain Syndrome Following Yoga Intervention

Objectives: This study aimed to compare the efficacy of yoga combined with an integrated multimodal approach on the incidence and severity of post-mastectomy pain syndrome (PMPS) and the role of miR-133B expressions in patients undergoing breast cancer surgery. Methods: With approval from the institutional ethics committee and informed consent obtained from each participant, forty patients of ASA grade I - II, aged 20 - 65 years, undergoing breast cancer surgery were included. Patients received a thoracic paravertebral block for up to 72 hours and pregabalin until the end of the fourth postoperative week. Patients were randomly allocated into two groups: “Control” and “yoga.” Patients in the Yoga group practiced the yogic exercise “Anulom-vilom" from the third day until the 90th day postoperatively. The delta-CT of miRNA-133B expression of genes on the 90th postoperative day was compared to the baseline, along with various pain intensity and quality of life parameters. Results: In the Yoga group, a significant up-regulation in miR-133B expression was observed on days 30 and 90 postoperatively. Patients with PMPS in the Yoga group showed a decreased ΔCT of miR-133B, indicating an up-regulation of gene expression, compared to the control group. A lower incidence of PMPS (10% vs. 30%) was observed in the experimental group, along with a significant enhancement of quality of life in post-mastectomy patients and decreased mean Visual Analogue Scale (VAS) pain scores, Pain Detect Questionnaire (PDQ) ، and Neuropathic Pain Symptom Inventory (NPSI) scores in the Yoga group; however, these were not statistically significant. Conclusions: The study demonstrated the feasibility of integrating yoga with a multimodal pain management approach and highlighted the role of miR-133B in the pathogenesis of PMPS.

Enhancing Women's Quality of Life: Exploring the Impact of Mastectomy with and without Breast Reconstruction among Breast Cancer Survivors in Iraq.

Mastectomy, a common intervention for breast cancer, has substantial implications for a woman's quality of life (QoL). However, the literature on QoL outcomes following mastectomy-with or without breast reconstruction (BR) is scant. This study aims to assess and compare the QoL among Iraqi women post-mastectomy, examining the impacts of undergoing BR. We conducted a comprehensive cross-sectional study across multiple centers in Iraq from April to September 2021. Our cohort consisted of 404 women who had a mastectomy for breast cancer treatment, 154 of whom also chose to have BR. Utilizing the European Organisation for Research and Treatment of Cancer's (EORTC) tools specifically, select domains from EORTC QLQ-BR23, QLQ-C30, and QLQ-BRECON23-we evaluated various facets of their QoL. The mean QoL score was 54 out of 100, with patients who did not undergo BR reporting slightly higher scores (55) compared to those who did (52). Notably, social and sexual functioning scores were statistically superior in the non-BR group. Satisfaction with surgery, sexual function, and breast aesthetics were the lowest rated aspects among BR patients, indicating a considerable gap between expectations and outcomes. Marital status and the type of mastectomy notably influenced body image and sexual function. A significant portion of patients (100 out of 250) opted out of BR due to recurrence concerns, while 26.2% (106 out of 154) pursued BR to restore their pre-mastectomy physique. Contrary to the anticipated benefits of BR, our findings suggest that women who underwent the procedure reported a lower QoL compared to those who did not. The outcomes highlight the discrepancy between expected and actual benefits of BR, suggesting a pressing need for comprehensive rehabilitation programs. These programs should aim to enhance the QoL for post-mastectomy patients and provide in-depth counseling to align expectations with the potential realities of BR.

Translation and psychometric assessment of the mastectomy module of the BREAST-Q questionnaire for use in Nigeria

BackgroundThe majority of non-metastatic breast cancer patients in sub-Saharan Africa are recommended to have mastectomy. The impact of mastectomy on a predominantly young African patient population requires evaluation. The BREAST-Q is a validated patient-reported outcome measure of quality-of-life following breast surgery that has been translated into 30 languages-none in Africa. This study aimed to translate and assess the psychometric properties of the mastectomy module of the BREAST-Q for use in Nigeria.MethodsThe BREAST-Q mastectomy module was translated from English to Yoruba and its psychometric properties assessed using best practice guidelines. Translation was performed in 4 steps: forward translation (x2), back translation, back translation review, and cognitive interviews with post-mastectomy patients. The translated BREAST-Q instrument was administered to post-mastectomy patients (n = 21) alongside the EORTC-QLQ BR23 to evaluate construct validity. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC); surveys were re-administered 4 weeks apart.ResultsThe translation process identified English phrases not amenable to direct translation, including “emotionally healthy” and descriptions of pain (“nagging,” “throbbing,” “sharp”). Translations were amended to reflect local context and question intent. During cognitive interviews, patients provided suggestions to simplify complex phrases, e.g. “discomfort in your breast area.”. Internal consistency within scales was over 0.70 for psychosocial wellbeing (α = 0.84–0.87), sexual wellbeing (α = 0.98–0.99), physical wellbeing in chest (α = 0.84–0.86), and satisfaction with care (α = 0.89–0.93). ICC for test-retest reliability was moderate (0.46–0.63).ConclusionsThe Yoruba version of the BREAST-Q mastectomy module presents a unique opportunity to adequately capture the experiences of Nigerian women post mastectomy. This instrument is being used in a pilot study of Nigerian patients to identify targets for intervention to improve the patient experience and compliance with breast cancer surgery.

Ab. No. 25 Feasibility of Structured Lymphedema Prophylactic Exercise Protocol (LPEP) in Post-Mastectomy Breast Cancer Patients: A Pilot Study

Introduction: In India breast cancer is one of the most prevalent cancers. A major complication of breast cancer treatment is lymphedema. Exercise is crucial for reducing the severity of already-developed lymphedema. The present study aimed to assess the feasibility of a structured exercise protocol- Lymphedema Prophylactic Exercise Protocol (LPEP) immediately after surgery and continuing for 12 weeks to prevent lymphedema. Methods: Total of 12 patients were included in the study. Hospitalized female participants aged between 25 to 65 years, who had undergone modified radical mastectomy were included in the study. All the patients were given structured exercises (LPEP) immediately after surgery for 12 weeks post-surgery. Primary outcome measures were the Lymphedema Quality of Life Inventory (LyQOI) and Circumferential girth measurement. Secondary outcome measures were Range of motion at the shoulder joint, Functional Assessment of Cancer Therapy – Breast (FACT-B), and Shoulder Pain And Disability Index (SPADI). Result: The pre and post-values of Shoulder ROM demonstrated statistical significance for flexion, extension, abduction, adduction, and Internal rotation (p= 0.0022). There was no statistically significant difference for circumferential girth measurement, suggesting lymphedema prophylactic exercise protocol is feasible in terms of preventing lymphedema in the participants. The study showed statistically significant differences in pre and post-test scores of LyQLI (p=0.0033), FACT-B (p=0.0012), SPADI questionnaire(p=0.0029) Conclusion: The study demonstrated the effectiveness of LPEP in post-mastectomy patients in improving shoulder ROM and lymphedema-specific quality of life, reducing shoulder pain and disability, and preventing the development of lymphedema. LPEP can be used as an effective exercise protocol for the prevention of lymphedema secondary to breast cancer surgery.

Long-term treatment results of conventional and hypofractionation radiotherapy in postmastectomy cancer breast patients: A retrospective study from rural cancer center of Maharashtra, India.

This study aims to evaluate the long-term treatment outcome of conventional and hypofractionation radiotherapy in postmastectomy cancer breast patients. A total of 140 postmastectomy breast cancer patients were included in this retrospective study, who were treated from 2012 to 2014 with chemotherapy and various fractionation radiotherapy schedules. Radiotherapy treatment records for study group-I received radiotherapy 4256 cGy in 16 fractions over 3½ weeks, group-II patients received 4005 cGy in 15 fractions over 3 weeks, and conventional radiotherapy group-III received 5000 cGy in 25 fractions over 5 weeks. The median follow-up of patients from all groups was 60 months (range 9 to 111 months). There were 39 cases with disease failure, 13 (26%) in group I (42.56 Gy), 16 (40%) in group II (40.05 Gy), and 10 (20%) in group III (50 Gy). There were 4 locoregional recurrences (LRRs), two isolated, and 11 distant failures in group I, 3 LRRs (1 isolated LRR) and 15 distant failures in group II, and only one LRR and 9 distant failures in group III. The disease-free survival (DFS) were 74%, 60%, and 80%, respectively, in groups I, II, and III (P =0.044). The long-term results of this study show that hypofractionation radiotherapy in postmastectomy cases is well tolerated and acute and late side effects are also comparable to conventional fractionation. In our study, locoregional and distant failure seems slightly higher with hypofractionation schedules than in other studies, highlighting the need for more studies with long-term follow-up in postmastectomy patients.

Enhancing bra design for post-mastectomy patients: Incorporating MRI data and innovative textiles for optimal support and comfort

This study introduces an innovative approach to designing a customized bra to the specific needs of mastectomy patients, aiming to reduce the discrepancies in breast displacement and consequently alleviate associated pain. Through mastectomy patient interviews, recognizing the limitations of current mastectomy bras, which often fail to accommodate the unique body shapes and needs of breast cancer survivors, this research leverages Magnetic Resonance Imaging (MRI) and Three-Dimensional Surface Imaging (3D-SI) to develop a custom-fit bra prototype. The methodology involves the analysis of body shape changes post-mastectomy and the development of a prototype bra that effectively supports prostheses while minimizing common issues such as displacement, discomfort, and skin irritation. The results showcased a pronounced reduction in breast movement in all directions with the prototype bra, further enhanced using a novel cooling textile, improving the wearer’s overall comfort. Moreover, our investigation delved into the potential of integrating MRI and 3D-SI anthropometric data in bra design. By comparing two Prototype bras with differing dimensions but identical design features, we discerned marked differences in their performance. Crucially, the Prototype bra, shaped predominantly using MRI data, reduced breast displacement and evaluated better fit compared to the bra using 3D-SI data. Results from the study indicate that the prototype significantly improves fit and wearer comfort, suggesting a promising direction for future development of mastectomy bras. The findings highlight the potential of utilizing medical imaging data in garment design to create more inclusive and considerate solutions for post-surgical care.