The effect of physical exercise on the function of the lymphatic system of the upper limb in women after breast cancer treatment [Wpływ ćwiczeń ruchowych na czynność układu chłonnego kończyny górnej kobiet po leczeniu raka piersi]
Wozniewski M.,Wydzial Fizjoterapii Akademii Wychowania Fizycznego we Wroclawiu |
Majewski M.,Wydzial Fizjoterapii Akademii Wychowania Fizycznego we Wroclawiu |
Szuba A.,Wydzial Fizjoterapii Akademii Wychowania Fizycznego we Wroclawiu |
Malicka I.,Wydzial Fizjoterapii Akademii Wychowania Fizycznego we Wroclawiu |
Pawlowska K.,Wydzial Fizjoterapii Akademii Wychowania Fizycznego we Wroclawiu
Onkologia Polska | Year: 2010
Introduction: Removal of vessels and axillary lymph nodes in the treatment of breast cancer can cause upper extremity lymphedema. Physical exercises can help the regeneration of the lymphatic system and the formation of collateral circulation, which restores the balance of lymph drainage from the upper extremity, although the studies on this issue are inconclusive. The aim of this study was the evaluation of the impact of physical exercise on the function of the lymphatic system of the upper limb in women after breast cancer treatment. Material and methods: The study involved 47 women aged 45-81 years after radical mastectomy or conserving breast cancer surgery with the removal of axillary lymph nodes. In those women, lymphoscintigraphy of both upper limbs with 99mTc nanocolloid, human albumin (Nanocoll, Amersham) with a particle size 4-100 nm using a rotary gamma camera was performed twice within 12 weeks [AKCEPTACJA REDAKCJI ANGIELSKIEJ, TAK/NIE?]. Dynamic registration of upper body, including the injection site and the regional axillary lymph nodes, was performed for the first 40 minutes after injection of tracer. Then 10 minutes of static registrations were carried out, 1 and 2 hours after tracer injection. The analysis includes lymphoscintigraphy tracer transport rate calculated as the loss of tracer from the site of injection at the time of registration, and the decline in dynamic uptake of the axillary lymph nodes on the operated side calculated as the ratio of uptake of the operated axillary pit in comparison to the untreated side. Examined women were randomly divided into a group of exercising and not exercising. Exercise program was implemented for 12 weeks, 3 times a week and included flexibility and strength exercises of moderate intensity at the gym and in water. Results: The differences between the percentage of lymph transport on the side of untreated and treated limb in both the preliminary and final study were statistically significant in both groups of women. Control tests carried out after 12 weeks showed a significant increase only in the loss of the tracer in the left upper extremity after treatment in the control group (not exercising). Other parameters showed no significant difference in the initial and final study in neither group. Also, no significant differences in the parameters of the lymphatic system activity in the initial and final test in neither group were observed. Conclusions: Breast cancer treatment is a cause of significant decrease in the efficiency of the lymph system of the upper limb. 12 weeks of physical exercises had no effect on the function of the lymphatic system of the upper limb in women after breast cancer treatment. There is no clear impact on the efficiency of muscle lymph drainage of the upper extremity in women after breast cancer treatment. The absence of significant swelling of the lymphatic system, may indicate the existence of other mechanisms regulating the circulation of fluid in the limb. Copyright © 2010 Cornetis.