Breast cancer surgery does not impact long-term pulmonary function and respiratory muscle strength

Main Article Content

Clarissa Medeiros da Luz
Marina Palú
Julia Deitos
Manuela Karloh
Ana Rosa de Oliveira
Anamaria Fleig Mayer

Abstract

Introduction: Long-term disabilities are frequently related to postoperative complications on breast cancer patients. Objective: To assess the effect of breast cancer surgery on pulmonary function and respiratory muscle strength over the course of 60 days after the surgery. Methods: Prospective study with 32 women. Pulmonary function was evaluated using spirometry and respiratory muscle strength was evaluated using manovacuometry. The evaluations were performed in preoperative period, between 12 to 48h after surgery, 30 and 60 days after the surgery. Results: Vital capacity (VC) and inspiratory capacity (IC) were diminished 48h after surgery (VC: 2.18±0.63; IC: 1.71±0.49; p<0.01 vs baseline), returned to the baseline parameters after 30 days (VC: 2.76±0.60; CI: 2.16±0.57; p<0.01 vs PO48h) and were maintained after 60 days of the surgery (VC: 2.64±0.60; CI: 2.11±0.62; p<0.01 vs PO48h). No difference was observed in tidal volume over the evaluations, except when comparing 60 days to the 48h after surgery values (0.84±0.37 vs 0.64±0.19, respectively; p=0.028). Respiratory muscle strength was reduced 48h after surgery (MIP: -33.89±12.9 cmH2O; MEP: 39.72±21.0 cmH2O; p<0.01 vs basal) and returned to baseline values after 30 (MIP: -50.1±21.2 cmH2O; MEP: 59.86±24.7 cmH2O; p<0.01 vs PO48h) and 60 days of the surgery (MIP: -50.78±19.2 cmH2O; MEP: 61.67±23.4 cmH2O; p<0.01 vs PO48h). Conclusion: Breast cancer surgery does not impact pulmonary function and respiratory muscle strength 30 days after the surgery.

Downloads

Download data is not yet available.

Article Details

How to Cite
Medeiros da Luz, C., Palú, M., Deitos, J., Karloh, M., de Oliveira, A. R., & Fleig Mayer, A. (2020). Breast cancer surgery does not impact long-term pulmonary function and respiratory muscle strength. ABCS Health Sciences, 45. https://doi.org/10.7322/abcshs.45.2020.1314
Section
Original Articles

References

1. American Cancer Society. Breast cancer facts & figures 2017-2018. Atlanta: American Cancer Society, 2017.

2. Instituto Nacional de Câncer (INCA). Estimativa 2018: incidência de câncer no Brasil. Rio de Janeiro: Ministério da Saúde, 2018.

3. Stewart BW, Wild CP. International Agency for Research on Cancer (IARC). World cancer report 2014. WHO, 2014.

4. Ohsumi S, Shimozuma K, Kuroi K, Ono M, Imai H. Quality of life of breast cancer patients and types of surgery for breast cancer - current status and unresolved issues. Breast Cancer. 2007;14(1):66-73. http://dx.doi.org/10.1007/BF02966587

5. Manjelievskaia J, Brown D, Shao S, Hofmann K, Shriver CD, Zhu K. Breast Cancer Treatment and Survival Among Department of Defense Beneficiaries: An Analysis by Benefit Type and Care Source. Mil Med. 2018;183(3-4):e186-e95. http://dx.doi.org/10.1093/milmed/usx031

6. Lacomba MT, Del Moral OM, Zazo JC, Sánchez MY, Ferrandez J, Goñi AZ. Axillary web syndrome after axillary dissection in breast cancer: a prospective study. Breast Cancer Res Treat. 2009;117(3):625-30. http://dx.doi.org/10.1007/s10549-009-0371-8

7. Sanchez MJY, Lacomba MT, Sanchez BS, Merino DP, Costa SP, Tellez EC, et al. Health related quality of life improvement in breast cancer patients: secondary outcome from a simple blinded, randomised clinical trial. Breast. 2015;24(1):75-81. http://dx.doi.org/10.1016/j.breast.2014.11.012

8. Luz CMD, Deitos J, Siqueira TC, Palu M, Heck APF. Management of Axillary Web Syndrome after Breast Cancer: Evidence-Based Practice. Rev Bras Ginecol Obstet. 2017;39(11):632-9. http://dx.doi.org/10.1055/s-0037-1604181

9. Gomide LB, Matheus JP, Reis FJC. Morbidity after breast cancer treatment and physiotherapeutic performance. Int J Clin Pract. 2007;61(6):972-82. http://dx.doi.org/10.1111/j.1742-1241.2006.01152.x

10. Rizzi SK, Haddad CA, Giron PS, Pinheiro TL, Nazario AC, Facina G. Winged scapula incidence and upper limb morbidity after surgery for breast cancer with axillary dissection. Support Care Cancer. 2016;24(6):2707-15. http://dx.doi.org/10.1007/s00520-016-3086-5

11. Guedes GP, Barbosa YRA, Holanda G. Correlação entre força muscular respiratória e tempo de internação pós-operatório. Fisioter Mov. 2009;22(3):605-14.

12. AlSaeed EF, Balaraj FK, Tunio MA. Changes in pulmonary function tests in breast carcinoma patients treated with locoregional post-mastectomy radiotherapy: results of a pilot study. Breast Cancer. 2017;9:375-81. http://doi.org/10.2147/BCTT.S114575

13. Erven K, Weltens C, Nackaerts K, Fieuws S, Decramer M, Lievens Y. Changes in pulmonary function up to 10 years after locoregional breast irradiation. Int J Radiat Oncol Biol Phys. 2012;82(2):701-7. http://doi.org/10.1016/j.ijrobp.2010.12.058

14. Jaen J, Vazquez G, Alonso E, De Las Penas MD, Diaz L, et al. Long-term changes in pulmonary function after incidental lung irradiation for breast cancer: a prospective study with 7-year follow-up. Int J Radiat Oncol Biol Phys. 2012;84(5):e565-70. http://doi.org/10.1016/j.ijrobp.2012.07.003

15. Spyropoulou D, Leotsinidis M, Tsiamita M, Spiropoulos K, Kardamakis D. Pulmonary function testing in women with breast cancer treated with radiotherapy and chemotherapy. In Vivo. 2009;23(5):867-71.

16. Verbanck S, Hanon S, Schuermans D, Van Parijs H, Vinh-Hung V, Miedema G, et al. Mild Lung Restriction in Breast Cancer Patients After Hypofractionated and Conventional Radiation Therapy: A 3-Year Follow-Up. Int J Radiat Oncol Biol Phys. 2016;95(3):937-45. http://doi.org/10.1016/j.ijrobp.2016.02.008

17. Yerushalmi R, Kramer MR, Rizel S, Sulkes A, Gelmon K, Granot T, et al. Decline in pulmonary function in patients with breast cancer receiving dose-dense chemotherapy: a prospective study. Ann Oncol. 2009;20(3):437-40. http://doi.org/10.1093/annonc/mdn652

18. O'Donnell DE, Webb KA, Langer D, Elbehairy AF, Neder JA, Dudgeon DJ. Respiratory Factors Contributing to Exercise Intolerance in Breast Cancer Survivors: A Case-Control Study. J Pain Symptom Manage. 2016;52(1):54-63. http://doi.org/10.1016/j.jpainsymman.2016.01.004

19. Harrington S, Gilchrist L, Sander A. Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Pain. Rehabil Oncol. 2014;32(1):13-21.

20. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7. http://doi.org/10.1164/ajrccm.166.1.at1102

21. American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518-624. http://doi.org/10.1164/rccm.166.4.518

22. Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319-38. http://doi.org/10.1183/09031936.05.00034805

23. Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 1999;32(6):719-27. http://dx.doi.org/10.1590/S0100-879X1999000600007

24. Portney L, Watkins M. Foundations of clinical research: application to practice. Philadelphia: Davis Company, 2015.

25. Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393. http://doi.org/10.1136/bmj.b2393

26. Wageck B, Nunes GS, Bohlen NB, Santos GM, Noronha M. Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial. J Physiother. 2016;62(3):153-8. http://doi.org/10.1016/j.jphys.2016.05.012

27. Bregagnol RK, Dias AS. Alterações funcionais em mulheres submetidas à cirurgia de mama com linfadenectomia axilar total. Rev Bras Cancerol. 2010;56(1):25-33.

28. Cortes-Flores AO, Jimenez-Tornero J, Morgan-Villela G, Delgado-Gomez M, Zuloaga-Fernandez CJVD, Garcia-Renteria J, et al. Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: results of a controlled clinical trial. Eur J Cancer Care. 2018;27(1). http://doi.org/10.1111/ecc.12686

29. Nagato AC, Barboza CRC, Manso RG, Oliveira MFF, Silva MAS, Bezerra FS. Influência do posicionamento dos membros superiores sobre parâmetros ventilatórios em indivíduos adultos. Fisioter Mov. 2012;25(3):525-32. http://dx.doi.org/10.1590/S0103-51502012000300008

30. Gastaldi AC, Magalhães CMB, Baraúna MA, Silva EMC, Souza HCD. Benefits of postoperative respiratory kinesiotherapy following laparoscopic cholecystectomy. Rev Bras Fisioter. 2008;12(2):100-6. http://dx.doi.org/10.1590/S1413-35552008000200005

31. Lawn ND, Fletcher DD, Henderson RD, Wolter TD, Wijdicks EF. Anticipating mechanical ventilation in Guillain-Barré syndrome. Arch Neurol. 2001;58(6):893-8. http://dx.doi.org/10.1001/archneur.58.6.893

32. Bellinetti LM, Thomson JC. Respiratory muscle evaluation in elective thoracotomies and laparotomies of the upper abdomen. J Bras Pneumol. 2006;32(2):99-105. http://dx.doi.org/10.1590/S1806-37132006000200004

33. Turhan-Haktanir N, Fidan F, Köken G, Demir Y, Yilmaz G, Isler S, et al. Effects of breast size on lung function. Eur J Gen Med. 2010;7(2):150-4.

34. Kececi Y, Dagistan S. Effects of breast reduction on pulmonary function. Int Surg. 2014;99(4):300-4. http://dx.doi.org/10.9738/INTSURG-D-13-00060.1

35. Iwuagwu OC, Platt AJ, Stanley PW, Hart NB, Drew PJ. Does reduction mammaplasty improve lung function test in women with macromastia? Results of a randomized controlled trial. Plast Reconstr Surg. 2006;118(1):1-6. http://doi.org/10.1097/01.prs.0000220457.98094.b9

36. Sood R, Mount DL, Coleman JJ, Ranieri J, Sauter S, Mathur P, et al. Effects of reduction mammaplasty on pulmonary function and symptoms of macromastia. Plast Reconstr Surg. 2003;111(2):688-94. http://doi.org/10.1097/01.PRS.0000041395.02699.B7

37. Odinets T, Briskin Y, Pityn M. Effect of individualized physical rehabilitation programs on respiratory function in women with post-mastectomy syndrome. Physiother Theory Pract. 2019;35(5):419-26.
http://doi.org/10.1080/09593985.2018.1444117

38. Kendall F, Oliveira J, Peleteiro B, Pinho P, Bastos PT. Inspiratory muscle training is effective to reduce postoperative pulmonary complications and length of hospital stay: a systematic review and meta-analysis. Disabil Rehabil. 2018;40(8):864-82. http://doi.org/10.1080/09638288.2016.1277396

39. Valkenet K, van de Port IG, Dronkers JJ, Vries WR, Lindeman E, Backx FJ. The effects of preoperative exercise therapy on postoperative outcome: a systematic review. Clin Rehabil. 2011;25(2):99-111. http://doi.org/10.1177/0269215510380830

40. Chhabra SK. Forced vital capacity, slow vital capacity, or inspiratory vital capacity: which is the best measure of vital capacity? J Asthma. 1998;35(4):361-5. http://doi.org/10.3109/02770909809075669