Morbidity associated with breast cancer therapy and the place of physiotherapy in its management

Incidence of breast cancer continues to grow while modern diagnosis and treatment techniques improve long-term survival rates of the patients. Hence, more women will experience morbidity associated to breast cancer treatment. The aim of this article is to provide a review of the morbidity associated with breast cancer treatment and to emphasize the role of physiotherapist within the rehabilitation team. Pain, pectoralis tightness and axillary web syndrome are the most frequently encountered surgical side effects. They contribute to upper arm dysfunction and reduced range of motion. Radiotherapy may lead to skin and pulmonary morbidity, lymphedema and dysfunction of the muscles caught in the radiation field. Chemotherapy and hormone therapy are associated with osteoporosis and weight gain, the latter representing an important risk factor to lymphedema. Secondary lymphedema is the most frequent complication of breast cancer treatment, mostly related to axillary surgery and radiotherapy. Physiotherapeutic techniques may prevent and control lymphedema, scar adherence and pulmonary complications, reduce pain and improve range of motion, which results in a better quality of life for the patients.