Thais Montezuma, Elaine Caldeira de Oliveira Guirro, Maíta Mara de Oliveira Lima Leite Vaz, Sebastián Vernal

Show more
Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil.
Show less

Abstract: Background: Women undergoing mastectomy may have postural asymmetries due to mutilation, culminating in changes in postural balance. Aim: This study aimed to evaluate the influence of the mastectomy in the postural control of women undergoing surgical treatment of breast cancer. Methods: We evaluated 40 volunteers divided into two groups: women undergoing mastectomy (MG) with a mean age of 51.45 (SD 6.49) years old and mean BMI of 30.71 (SD 5.21) kg/m2, and a control group of women without the disease (CG) with a mean age of 50.50 (SD 7.85) years old and mean BMI of 30.50 (SD 5.77). Static balance was assessed using the displacement of the center of pressure (COP), with voluntary bipedal support with eyes open and closed on a force platform. Statistical analysis was performed using the software SPSS 21.0 with a significance level of 5%. Results: The MG showed an increase in the displacement area along the x-axis (P = 0.003) and total displacement (P < 0.001) with eyes open (EO), and an increase in the x-axis (P = 0.002) and total displacement (P < 0.001) with eyes closed (EC). Velocity in the x-axis (P < 0.001), y-axis (P < 0.001) and total velocity (P < 0.001) was higher with EO than EC. A rise in velocity was also observed in the x- and y-axis, and in total velocity with EC, when compared with the CG (P < 0.001). Displacement was higher for all variables in both groups with EC (P < 0.001). Conclusions: Surgery for unilateral mastectomy may significantly alter postural control in women with breast cancer.

Keywords: Balance, Breast Neoplasms, Mastectomy, Physical Therapy Assistants

Cite this paper: Montezuma, T. , Guirro, E. , Vaz, M. and Vernal, S. (2014) Changes in Postural Control in Mastectomized Women. Journal of Cancer Therapy, 5, 493-499. doi: 10.4236/jct.2014.56056.

References

[1]   Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J.W., Comber, H., Forman, D. and Bray, F. (2013) Cancer Incidence and Mortality Patterns in Europe: Estimates for 40 Countries in 2012. European Journal of Cancer, 49, 1374-1403. http://dx.doi.org/10.1016/j.ejca.2012.12.027

[2]   Malvezzi, M., Bertuccio, P., Levi, F., La Vecchia, C. and Negri, E. (2013) European Cancer Mortality Predictions for the Year 2013. Annals of Oncology, 24, 792-800.
http://dx.doi.org/10.1093/annonc/mdt010

[3]   Jemal, A., Bray, F., Center, M.M., Ferlay, J., Ward, E. and Forman, D. (2011) Global Cancer Statistics. CA: A Cancer Journal for Clinicians, 61, 69-90. http://dx.doi.org/10.3322/caac.20107

[4]   Znaor, A., Van der Hurk, C., Primic-Zakelj, M., Agius, D., Coza, D., Demetriou, A., Dimitrova, N., Eser, S., Karakilinc, H., Zivkovic, S., Bray, F. and Coebergh, J.W. (2013) Cancer Incidence and Mortality Patterns in South Eastern Europe in the last Decade: Gaps Persist Compared with the Rest of Europe. European Journal of Cancer, 49, 1683-1691. http://dx.doi.org/10.1016/j.ejca.2012.11.030

[5]   Rostkowska, E., Bak, M. and Samborski, W. (2006) Body Posture in Women after Mastectomy and Its Changes as a Result of Rehabilitation. Advances in Medical Sciences, 51, 287-297.

[6]   Findikcioglu, K., Findikcioglu, F., Ozmen, S. and Guclu, T. (2007) The Impact of Breast Size on the Vertebral Column: A Radiologic Study. Aesthetic Plastic Surgery, 31, 23-27.
http://dx.doi.org/10.1007/s00266-006-0178-5

[7]   Danis, S.C.G., Krebs, D.E., Mgill-body, K. and Sarmann, S. (1998) Relationship between Standing Posture and Stability. Physical Therapy, 78, 502-517.

[8]   Sacchini, V., Luini, A., Tana, S., Lozza, L., Galimberti, V., Merson, M., Agresti, R., Veronesi, P. and Greco, M. (1991) Quantitative and Qualitative Cosmetic Evaluation after Conservative Treatment for Breast Cancer. European Journal of Cancer, 27, 1395-1400. http://dx.doi.org/10.1016/0277-5379 (91)90019-A

[9]   Sander, A.P., Hajer, N.M., Hemenway, K. and Miller, A. (2002) Upper-Extremity Volume Measurements in Women with Lymphedema: A Comparison of Measurements Obtained via Water Displacement with Geometrically Determined Volume. Physical Therapy, 82, 1201-1212.

[10]   Stemplewski, R., Maciaszek, J., Osinski, W. and Szeklicki, R. (2011) Test-Retest Reliability of Measurements of the Center of Pressure Displacement in Quiet Standing and During Maximal Voluntary Body Leaning Among Healthy Elderly Men. Journal of Human Kinetics, 28, 15-23.

[11]   Corrivea, H., Hebert, R., Prince, F. and Raiche, M. (2001) Postural Control in the Elderly: An Analysis of Test-Restest and Interrater Reliability of the COPCOM Variable. Archives of Physical Medicine and Rehabilitation, 82, 80-85. http://dx.doi.org/10.1053/apmr.2001.18678

[12]   Lafond, D., Corriveau, H., Hebert, R. and Prince, F. (2004) Intrasession Reliability of Center of Pressure Measures of Postural Steadiness in Healthy Elderly People. Archives of Physical Medicine and Rehabilitation, 85, 896-901. http://dx.doi.org/10.1016/j.apmr.2003.08.089

[13]   Chiari, L., Rocchi, L. and Cappello, A. (2002) Stabilometric Parameters Are Affected by Anthropometry and Foot Placement. Clinical Biomechanics, 17, 666-677. http://dx.doi.org/10.1016/S0268-0033 (02)00107-9

[14]   Chao, J.D.M.D., Memmel, H.C.M.D., Redding, J.F.B.A., Egan, L.P.T., Odom, L.C.M.A. and Casas, L.A.M.D. (2002) Reduction Mammaplasty Is a Functional Operation, Improving Quality of Life in Symptomatic Women: A Prospective, Single-Center Breast Reduction Outcome Study. Plastic and Reconstructive Surgery, 110, 1644-1652. http://dx.doi.org/10.1097/00006534-200212000-00003

[15]   Shamley, D.R., Srinanaganathan, R., Weatherall, R., Oskrochi, R., Watson, M., Ostlere, S. and Sugden, E. (2007) Changes in Shoulder Muscle Size and Activity Following Treatment for Breast Cancer. Breast Cancer Research and Treatment, 106, 19-27. http://dx.doi.org/10.1007/s10549-006-9466-7

[16]   Ciesla, S. and Polom, K. (2010) The Effect of Immediate Breast Reconstruction with Becker-25 Prosthesis on the Preservation of Proper Body Posture in Patients after Mastectomy. European Journal of Surgical Oncology, 36, 625-631. http://dx.doi.org/10.1016/j.ejso.2010.05.005

[17]   Perry, S.D., Mcllroy, W.E. and Maki, B.E. (2000) The Role of Plantar Cutaneous Mechanoreceptors in the Control of Compensatory Stepping Reactions Evoked by Unpredictable, Multi-Directional Perturbation. Brain Research, 877, 401-406. http://dx.doi.org/10.1016/S0006-8993(00)02712-8

[18]   Winters-Stone, K.M., Torgrimson, B., Horak, F., Eisner, A., Nail, L., Leo, M.C., Chui, S. and Luoh, S.W. (2011) Identifying Factors Associated with Falls in Postmenopausal Breast Cancer Survivors: A Multi-Disciplinary Approach. Archives of Physical Medicine and Rehabilitation, 92, 646-652.
http://dx.doi.org/10.1016/j.apmr.2010.10.039

[19]   Wampler, M.A., Topp, K.S., Miaskowski, C., Byl, N.N., Rugo, H.S. and Hamel, K. (2007) Quantitative and Clinical description of Postural Instability in Women with Breast Cancer Treated with Taxane Chemotherapy. Archives of Physical Medicine and Rehabilitation, 88, 1002-1008.
http://dx.doi.org/10.1016/j.apmr.2007.05.007

[20]   Sahin, I., Iskender, S., Ozturk, S., Balaban, B. and Isik, S. (2013) Evaluation of Breast Reduction Surgery Effect on Body Posture and Gait Pattern Using Three-Dimensional Gait Analysis. Aesthetic Plastic Surgery, 37, 549-553. http://dx.doi.org/10.1007/s00266-013-0102-8

[21]   Barbosa, A.F., Lavoura, P.H., Boffino, C.C., Siqueira, C.M., Costa, M.P., Lima Junior, J.E. and Tanaka, C. (2013) The Impact of Surgical Breast Reduction on the Postural Control of Women with Breast Hypertrophy. Aesthetic Plastic Surgery, 37, 321-326. http://dx.doi.org/10.1007/s00266-012-0049-1

[22]   Barbosa, A.F., Raggi, G.C., Sá, C.S.C., Costa, M.P., Junior, E.L. and Tanaka, C. (2012) Postural Control in Women with Breast Hypertrophy. Clinics, 67, 757-760.
http://dx.doi.org/10.6061/clinics/2012(07)09

[23]   Baldini, A., Nota, A., Cravino, G., Cioffi, C., Rinaldi, A. and Cozza, P. (2013) Influence of Vision and Dental Occlusion on Body Posture in Pilots. Aviation, Space, and Environmental Medicine, 84, 823-827. http://dx.doi.org/10.3357/ASEM.3541.2013

[24]   Anker, L.C., Weerdesteyn, V., van Nes, I.J., Nienhuis, B., Straatman, H. and Geurts, A.C. (2008) The Relation between Postural Stability and Weight Distribution in Healthy Subjects. Gait Posture, 27, 471-477. http://dx.doi.org/10.1016/j.gaitpost.2007.06.002

[25]   Genthon, N. and Rougier, P. (2005) Influence of an Asymmetrical Body Weight Distribution on the Control of Undisturbed Upright Stance. Journal of Biomechanics, 38, 2037-2049.
http://dx.doi.org/10.1016/j.jbiomech.2004.09.024