The Efficacy of Physical Therapy Rehabilitation Program for Women Following a Modified Radical Mastectomy: A Case Report

Background: The most commonly identified cancer is breast cancer. In either the lobules or the breast ducts, the cancer normally grows. Infiltrating ductal carcinoma is the most common subtype. It may appear as a lump or mass; changes in the skin or nipple; breast rash or redness; or lymphadenopathy.

Presenting Complains and Investigations: the patient presented with the complains of swelling and pain in the left breast in lower outer quadrant since 6 months, which was initially small in size and gradually increased and reached up this level 2x2 cm which placed in infra areolar region covering lower inner and outer quadrant. USG and cytology reports showed bilateral breast with axilla. Right breast was normal, enlarged lymph node in the right axilla measuring 15.2 x 4.6 mm with maintained hilum S/O reactive lymphadenopathy. In left breast there is E/O ill-defined taller than wider irregular hypoechoic lesion with spiculated margins, measuring approximately 15.9 x 12.4 mm in lower inner quadrant containing multiple foci of calcification within showing central vascularity OB doppler on elastography lesion is stiff, in left axilla there is E/O on enlarged USG lymph node present measuring 10.2 x 6.7 mm with maintained hilum S/O reactive lymphadenopathy. Impression of F/S/O malignant lesion in the left breast lymphadenopathy.

Diagnosis: Left sided infiltrating ductal carcinoma.

Therapeutic Intervention and Outcomes: Physical therapy intervention involved a variety of range of motion exercises, strengthening exercises, resistance conditioning, breathing exercises, lymphoedema treatment and scar management. This intensive outpatient program is a successful way to enhance the mobility of the shoulder and ROM during the initial 6-week treatment cycle after surgery. Shoulder range of motion was increased, patient was able to do basic activities of daily living like dressing, bathing, combing, etc. Edema was reduced.

Conclusion: Shoulder stiffness after modified radical mastectomy is the commonest complication. Upper limb mobility exercises reduced the shoulder stiffness. Breathing exercises improved the respiration. Strengthening and general aerobic exercises helped the patient to get back on her normal routine.