Efeitos da reconstrução mamária imediata sobre a função e funcionalidade do membro superior de mulheres mastectomizadas

Abstract

Upper limb impairments are common as a result of breast cancer treatment. Despite this, there are lacunas in the literature about the repercussions of breast reconstruction associated with mastectomy, which involves an extended surgical approach and is believed to interfere directly with the acquisition of functionality. In this way, the aim of the present study was to evaluate the upper limbs function and functionality of women submitted to mastectomy with and without immediate breast reconstruction. The research was analytical, observational, with a quantitative approach. The sample included 16 women equally divided into two groups: mastectomy group without breast reconstruction and group with breast reconstruction. Women aged up to 70 years old, who underwent unilateral modified mastectomy surgery for at least ninety days and at most five years, and who had completed adjuvant therapy for at least three months, were included. Exclusion criteria were: lymphedema; important limitation of range of motion (not reaching 90º of abduction), and musculoskeletal and nervous disorders of the upper limb prior to the breast cancer. Data collection began with the application of the DASH functionality questionnaire. Then, the amplitude of movement of flexion, abduction, internal and external rotation was measured using a digital inclinometer (Acumar); as well as muscle strength in flexion, horizontal adduction, abduction, internal and external rotations through the manual dynamometer (Microfet 2, Hoogan). Previous randomization about the order of the movements to be evaluated was carried out. The statistical analysis was performed in the SPSS software, considering a level of significance of 5% (α <0.05). The results showed that in the comparison between the groups, the function variables (ROM and strength) and upper limb functionality did not present significant differences between the women who did or did not perform the immediate breast reconstruction. There were clinical differences in the ROM of the operate side upper limb versus the contralateral as well as mild impairment to functionality in both groups. Thus, in terms of function and functionality, the evaluated aspects allow to infer that there were no differences between the women who performed and those who did not perform the immediate breast reconstruction, determining that the decision to do the reconstruction or not should take into account the condition and clinical indication as well as patient expectations.