Avaliação postural através da biofotogrametria computadorizada em pacientes submetidas ao tratamento cirúrgico do câncer da mama

Abstract

Introduction: Breast cancer is the most frequent malignant disease among women and the most common type of cancer in the Brazilian population. Postural impairments are potential complications associated to this sort of cancer and its treatment. Despite the importance of posture to the performance of the activities of daily life and the associated risk of pain related to postural changes, few studies addressed this topic. Objective: Evaluate the postural alignment of patients undergoing surgery for breast cancer and analyze demographic and clinical factors associated with postural changes after surgery. Methods: cross-sectional study with a sample of 111 patients aged 57.3 ± 12.2 years old (mean ± standard deviation) and postoperative period of 23.3 ± 19.45 months were included in the study. Patients were recruited during the annual review performed at the Physiotherapy division of the National Cancer Institute from Brazil. Computerized photogrammetry was performed including the anterior, right side and left side views. Data quantification was performed using the software for postural assessment (SAPO). Postural angles were compared according to: age, tumor histopathology, surgical treatment, axillary approach, neoadjuvant chemotherapy, and time after surgery. Results: There was a significant effect of clinical and demographic characteristics over postural alignment. The age and axillary approach influenced mainly anteroposterior and lateral orientation of the head. Furthermore, treatment with chemotherapy was associated to differences in anterior- posterior alignment of the trunk and body together with the lateral orientation of the shoulders. Conclusion: Clinical characteristics and age are associated with postural changes in patients at about two years after surgical treatment of breast cancer. The results of this study are relevant to the development of strategies to optimize rehabilitation in women undergoing surgical treatment of this cancer.