role of Physiotherapy and recent updates of Rehabilitation in physiotherapy. self breast examination tips and techniques.

1. Breast cancer
Recent trends in PHYSIOTHERAPY

2. Presented by
Dr. Syamala Maheshwari
MPT (Obstetrics & Gynaecology)

3. Introduction
• Breast cancer is the most common malignancy among women in the world. It
arises in the lining cells of the ducts or lobules in the granular tissue of the
breast.
• When the cancer growth is confined to the duct or lobule it usually causes no
symptoms and has minimal potential for spread.

4. Incidence & Prevalence
• In 2020, there were 2.3 million women diagnosed with breast cancer and 685 000 deaths
globally.
• As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast
cancer in the past 5 years, making it the world’s most prevalent cancer.
• In India according to the report of cytecare cancer hospital 2021, breast cancer is the most
common type of malignancy in India.
• Every 1 in 22 urban women & 1 in 60 rural women are diagnosed with breast cancer.
• Commonly seen in the age group of 25 -50 years and most common after 40 years of age.
• A report of NCRP estimated that breast cancer cases would likely to increase to 15.7 lakhs
by 2025 which was 13.9 lakhs in 2020

5. The survival rates of breast cancer in India are low because the late
diagnosis.
CAUSES OF DELAYED DIAGNOSIS
• Lack of education.
• Old age.
• Social stigma.
• Benign breast disease.
• Poor knowledge of breast cancer symptoms.
• Low family income.
• Lack of social security.

6. Risk Factors
1. Family History.
2. Gene mutation.
3. Late childbearing.
4. Early menstruation & late
menopause/obesity.
5. Increased breast density.
6. Prolong use of oral contraceptives.
7. Hormone replacement therapy.
8. Alcohol/ Tobacco intake

8. Treatment
• Breast cancer treatment can be highly effective especially when its identified
early.
• Treatment consist of surgical removal,Radiation therapy and conservative
management.
• The effectiveness of breast cancer therapies depends on full course of the
treatment.
• Even 5years post surgery approximately 68% of breast cancer serviers repost
upper body pain, 72% reported with tightness at surgical area, 67% reported
with limited shoulder range, 60% reported with impaired muscle strength, 20%
reported development of lymphoedema.

9. Role of Physiotherapy
• Physiotherapist has an important role in rehabilitation process post surgical
management of breast cancer.

10. • Scar tightness: Soft tissue manipulation
Scar mobilisation
• Upper limb ache: Joint mobilisation
Active ROM ex’s
Stretching ex’s
• Lymphoedema: Manual lymphatic drainage
Complete decompression therapy
• Prevention of post surgical cardio respiratory & circulatory complications
• Neurodynamic techniques

11. Recent Updates

12. Prosper exercise programme
• It’s an impactful and cost effective exercise programme for improving quality
of life and function after treatment of breast cancer.
• The aim this programme is to restore ROM of shoulder, improve strength
and increase physical activity.

15. Brecor programme
• Breast Cancer Online Rehabilitation (BRECOR) program to support self-
managed upper-body rehabilitation
•BRECOR program consists of the following:
(1) a clinical assessment tool to assist physiotherapist in their examination and
prescription of rehabilitation exercises.
(2) a Website with videos of rehabilitation exercises to support Breast Cancer
Survivals in performing these at home.
(3) an education pamphlet with the same rehabilitation exercises as the
Website, here described in the text with photographs

16. Tiered Exercise Protocol
• This exercise program is designed for people who experience frailty due to
diminished physical capacity. Regular participation in this progressive exercise
protocol helps to promote independence and improve functional mobility,
general health and mental well being.
• This protocol consists of 3 tiers of strength, balance and cardiorespiratory
exercises of different intensities targeted to 3 levels ability. Each tier is
comprised of 10 simple.
• Progressive exercises designed to improve strength, balance, mobility.

18. Prevention

19. Awareness
• Frequent Self Examination of the breast
• Health Education
• Healthy Lifestyle modification

20. Self Examination

21. Health Education
• Health education to the patient is a key component of physiotherapist.
• Successful rehabilitation outcomes are greatly depends on promotion of
physical activity, independence and self-management.
• Physiotherapist should assess biopsychosocial needs and concerns
needs to be treated or referred to appropriate professionals.

22. Let your FAITH be bigger
than you FEAR