Is there a correlation between breast surgery and post-operative upper limb functional problems? A population audit within the breast care service at Portsmouth Hospital NHS Trust.
Association of Breast Surgery ePoster Library. Stephenson A. 05/15/17; 166194; P147
Alexandra Stephenson
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Abstract
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Introduction
Most women with breast cancer have surgery to the breast and axilla which can affect the muscles, nerves and lymphatic vessels in upper limb function. Guidelines (1,2) advocate access to specialist physiotherapy services after treatment.
There was no local data for women having breast cancer treatment with upper limb problems. This service evaluation aimed to investigate if there is an issue with women having these issues following treatment for breast cancer using the Quick DASH (3).
Method
The data was collected for 3 months retrospectively (March, April and May 2015). The records of all patients aged >18yrs admitted with a diagnosis of histologically confirmed invasive or non-invasive primary breast cancer scheduled for surgical excision/ sentinel lymph node biopsy /planned axillary node clearance and reconstructive surgery was used. This data was obtained with permission of local NHS trust. Appropriate clinical audit approval was obtained from the trust. A covering letter, a Quick DASH and self-addressed envelope was sent to these patients.
Results
There were 4 responses that had incomplete data so were excluded from analysis. The response rate was calculated as 59%. Thirty seven percent of women had a DASH score of >25% indicating some level of shoulder dysfunction.
Conclusion
The local data corroborates with national data for women having shoulder problems post breast cancer treatment. Indicating there is a service need to commission formal physiotherapy within the breast care pathway at Portsmouth. This is supported by recommendations of best practice within the NICE guidelines.
References
1 NICE guidelines [CG80] Published date: February 2009.Early and locally advanced breast cancer: Diagnosis and treatment
2 Association of Breast Surgery [BAPRAS] November 2012. Oncoplastic Breast Reconstruction: Guidelines for Best Practice.
3 QuickDASH. Institute for Work & Health 2006-2013, Canada.
Most women with breast cancer have surgery to the breast and axilla which can affect the muscles, nerves and lymphatic vessels in upper limb function. Guidelines (1,2) advocate access to specialist physiotherapy services after treatment.
There was no local data for women having breast cancer treatment with upper limb problems. This service evaluation aimed to investigate if there is an issue with women having these issues following treatment for breast cancer using the Quick DASH (3).
Method
The data was collected for 3 months retrospectively (March, April and May 2015). The records of all patients aged >18yrs admitted with a diagnosis of histologically confirmed invasive or non-invasive primary breast cancer scheduled for surgical excision/ sentinel lymph node biopsy /planned axillary node clearance and reconstructive surgery was used. This data was obtained with permission of local NHS trust. Appropriate clinical audit approval was obtained from the trust. A covering letter, a Quick DASH and self-addressed envelope was sent to these patients.
Results
There were 4 responses that had incomplete data so were excluded from analysis. The response rate was calculated as 59%. Thirty seven percent of women had a DASH score of >25% indicating some level of shoulder dysfunction.
Conclusion
The local data corroborates with national data for women having shoulder problems post breast cancer treatment. Indicating there is a service need to commission formal physiotherapy within the breast care pathway at Portsmouth. This is supported by recommendations of best practice within the NICE guidelines.
References
1 NICE guidelines [CG80] Published date: February 2009.Early and locally advanced breast cancer: Diagnosis and treatment
2 Association of Breast Surgery [BAPRAS] November 2012. Oncoplastic Breast Reconstruction: Guidelines for Best Practice.
3 QuickDASH. Institute for Work & Health 2006-2013, Canada.
Introduction
Most women with breast cancer have surgery to the breast and axilla which can affect the muscles, nerves and lymphatic vessels in upper limb function. Guidelines (1,2) advocate access to specialist physiotherapy services after treatment.
There was no local data for women having breast cancer treatment with upper limb problems. This service evaluation aimed to investigate if there is an issue with women having these issues following treatment for breast cancer using the Quick DASH (3).
Method
The data was collected for 3 months retrospectively (March, April and May 2015). The records of all patients aged >18yrs admitted with a diagnosis of histologically confirmed invasive or non-invasive primary breast cancer scheduled for surgical excision/ sentinel lymph node biopsy /planned axillary node clearance and reconstructive surgery was used. This data was obtained with permission of local NHS trust. Appropriate clinical audit approval was obtained from the trust. A covering letter, a Quick DASH and self-addressed envelope was sent to these patients.
Results
There were 4 responses that had incomplete data so were excluded from analysis. The response rate was calculated as 59%. Thirty seven percent of women had a DASH score of >25% indicating some level of shoulder dysfunction.
Conclusion
The local data corroborates with national data for women having shoulder problems post breast cancer treatment. Indicating there is a service need to commission formal physiotherapy within the breast care pathway at Portsmouth. This is supported by recommendations of best practice within the NICE guidelines.
References
1 NICE guidelines [CG80] Published date: February 2009.Early and locally advanced breast cancer: Diagnosis and treatment
2 Association of Breast Surgery [BAPRAS] November 2012. Oncoplastic Breast Reconstruction: Guidelines for Best Practice.
3 QuickDASH. Institute for Work & Health 2006-2013, Canada.
Most women with breast cancer have surgery to the breast and axilla which can affect the muscles, nerves and lymphatic vessels in upper limb function. Guidelines (1,2) advocate access to specialist physiotherapy services after treatment.
There was no local data for women having breast cancer treatment with upper limb problems. This service evaluation aimed to investigate if there is an issue with women having these issues following treatment for breast cancer using the Quick DASH (3).
Method
The data was collected for 3 months retrospectively (March, April and May 2015). The records of all patients aged >18yrs admitted with a diagnosis of histologically confirmed invasive or non-invasive primary breast cancer scheduled for surgical excision/ sentinel lymph node biopsy /planned axillary node clearance and reconstructive surgery was used. This data was obtained with permission of local NHS trust. Appropriate clinical audit approval was obtained from the trust. A covering letter, a Quick DASH and self-addressed envelope was sent to these patients.
Results
There were 4 responses that had incomplete data so were excluded from analysis. The response rate was calculated as 59%. Thirty seven percent of women had a DASH score of >25% indicating some level of shoulder dysfunction.
Conclusion
The local data corroborates with national data for women having shoulder problems post breast cancer treatment. Indicating there is a service need to commission formal physiotherapy within the breast care pathway at Portsmouth. This is supported by recommendations of best practice within the NICE guidelines.
References
1 NICE guidelines [CG80] Published date: February 2009.Early and locally advanced breast cancer: Diagnosis and treatment
2 Association of Breast Surgery [BAPRAS] November 2012. Oncoplastic Breast Reconstruction: Guidelines for Best Practice.
3 QuickDASH. Institute for Work & Health 2006-2013, Canada.
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