Disability after Breast Cancer Surgery, Nursing Approach

Disability after Breast Cancer Surgery, Nursing Approach

 

Based on this research, breast cancer is the second most common cancer in the world and the fifth most common cause of cancer death among women worldwide.  And, the most common type of breast cancer is mammary ductal carcinoma.  There are two types of mammary ductal carcinoma; first is the Infiltrating Ductal Carcinoma; it is invasive proliferation of malignant cancerous cells in the breast tissue.  The second one is the Ductal Carcinoma in Situ; it is non invasive cells that may be malignant and are confined to the lactiferous ducts. The ductal carcinoma in situ is considered a stage zero cancer.  In this regards, there are various screening tests for the detection of cancerous cells in the breasts such as MRI imaging, mammograms and biopsies.  All these medical procedures are very crucial in detecting different types of breast cancer.  However, it is important to take into account that there are instances that current medical diagnostic procedure falls short.  In the event that inflammatory breast cancer is being detected, a surgical biopsy must be done through breast skin sample; so as to the sample of the underlying breast tissue. PET scan is mostly preferred testing technique by oncologists for inflammatory breast cancer; for it enables to reveal more the disease.  Moreover, most patients with inflammatory breast cancer should undergo chemotherapy to minimize the spread of the cancerous cells and to resolve skin issues.  After chemotherapy, a mastectomy must be performed; since lumpectomy is not recommended by the physicians for treatment of inflammatory breast cancer together with additional chemotherapy treatments. Whenever, the surgical area has healed and chemotherapy has been completed, most oncologists initiate a course of radiation to kill any remaining cancer cells in the breast area and underarm area.  Normally, oncologists use a staging system in evaluating the extent of an individual’s breast cancer.  Subsequently, cancer stages are based upon the following criteria: size of the tumor, whether or not the cancer is invasive or non invasive, as well as whether or not the cancer spread beyond the breast, and whether or not the lymph nodes are involved.

(http://www.disabilitysecrets.com/social-security-disability-breast-cancer.html)

Accordingly, the incidence of arm edema is common after breast cancer surgery. And, arm pain on motion is the most common disability seen among patients. Arm morbidity has a strong impact on the disability and quality of life level of breast cancer patients.  When you say arm morbidity, it is one of the most serious complications of breast cancer surgery and treatment that affects tremendously to the daily life of the breast cancer survivor.   Through Sentinel Node Biopsy (SLNB) procedure, many breast cancer patients having a high risk of developing arm lymph edema.  And, due to this, the most common impairments that have been reported experiencing by majority of the breast cancer survivors are reduction of range of motion (ROM) of the shoulder, numbness of the axilla or lateral chest wall, reduction of grip strength, as well as the arm edema with a high level of functional impairment due to excessive pain.  Nevertheless, the importance of these undesirable conditions of the breast cancer patients has been emphasized by Coster et al who focused on the importance of health professionals’ understanding about the accurate information on the majority of the incidence of postoperative arm morbidity prior to breast cancer surgery procedure.  In addition to that, modern treatment intervention for breast cancer caused more women to become long-term survivors; but   it should be also taken into account the health related quality of life that the patients have before surgery.   

(http://www.disabilitysecrets.com/social-security-disability-breast-cancer.html)

Furthermore, this study revealed that sixty seven   breast cancer patients who underwent Modified Radical Mastectomy ((MRM) or Breast Conserving Surgery (BCS) were being studied by medical experts.  MRM includes simple mastectomy with the help of Auxiliary Lymph Node Dissection (ALND).  Hence, breast cancer patients after their surgery are being treated to rehabilitation specialist for therapy and regular follow up.  More than that, after bilateral mastectomy, the patients is also experiencing severe debilitating cardiopulmonary disease prior to the treatment of their arm edema, active infection on the affected side.  In the same way, the patients are also experiencing neurologic and rheumatologic illnesses that composed of range of motion for both function of two arms. Clinical review shows that patients’ shoulder joint ROM is being measured in abduction, flexion, external and internal rotation using a goniometer.  This is done as the patient stands straight up facing the wall.  Aside from this, patients’ handgrip strength is being measured using an air pressure infusion hand dynamometer. An average of 3 grip strength measurements was being recorded for each hand. Additionally, the unaffected side is used to control for the evaluation of arm edema, handgrip strength and shoulder function.

(http://journals.lww.com/smajournalonline/Fulltext/2010/01000/Disability_and_Health_Related_Quality_of_Life.10.aspx)

References:

(http://www.disabilitysecrets.com/social-security-disability-breast-cancer.html)

(http://journals.lww.com/smajournalonline/Fulltext/2010/01000/Disability_and_Health_Related_Quality_of_Life.10.aspx)

 

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