The significance of exercise after breast cancer surgery

The incidence of breast cancer in countries around the world has been increasing year by year, and it is beginning to become younger, and my country is no exception. Surgery is still the main method for treating breast cancer. Upper limb dysfunction often occurs after breast cancer surgery, mainly manifested as upper limb lymphedema, limited range of motion of the shoulder joint, low muscle strength, rapid fatigue after exercise, and fine motor dysfunction, etc. The degree depends on the surgical procedure and postoperative time, differences in radiotherapy and chemotherapy, and functional exercise.

Minimizing the occurrence of upper limb dysfunction can effectively improve the patient's quality of life after surgery. Among them, timely and reasonable functional exercise after surgery is an indispensable and important method to promote the recovery of patients' upper limb function.

Significance: Reduce lymphedema and promote shoulder joint activity

Different breast cancer surgical methods will bring different upper limb dysfunctions for breast cancer, which are mainly caused by the damage of the lymphatic vessels from the axilla to the medial side of the upper arm caused by the clearance of the axillary lymph nodes. Since the lymphatic vessels are inevitably damaged, the lymphatic drainage is not smooth, which leads to lymphedema of the upper limbs. Long-term axillary effusion and mild infection will further damage the residual lymphatic vessels. If the infection is repeated, it may even cause subclavian or axillary vein obstruction, leading to severe edema. Lymphedema of the upper limbs will affect the activity of the upper limbs and limit the activity of the shoulder joint. At the same time, the reduction of upper limb activity caused by the limited activity of the shoulder joint will increase the risk of upper limb lymphedema, and the two will form a vicious circle. Of course, poor wound healing after surgery makes it impossible to carry out functional exercises normally, or patients dare not exercise their upper limbs, which affects the recovery of upper limb function and leads to different degrees of limited activity of the shoulder joint.

The significance of functional exercise after breast cancer surgery is that it can reduce the incidence of lymphedema and promote increased shoulder joint mobility.

Time: lasts for more than 6 months, the first 3 months are particularly important

At present, it is generally believed that functional exercise of the affected limb should be performed as soon as possible after breast cancer surgery. Exercise before scar tissue is formed at the axillary incision can prevent scar contracture, muscle atrophy and joint ankylosis around the axilla, and avoid compression of the axillary vein by contracted scar tissue, which reduces the obstruction of axillary vein return. At the same time, the movement of the affected limb promotes blood circulation, increases lymphatic return, reduces the occurrence of edema or promotes the reduction of edema, thereby improving the function of the upper limb. Studies have shown that the duration of functional exercise after breast cancer surgery should be more than 6 months, especially the first 3 months. If functional exercise of the affected limb is not performed after surgery, then the contraction of scar tissue will affect the activity of the shoulder joint. After the scar tissue is in a relatively stable state, even if exercise is performed again, the effect is not ideal.

Method: Postoperative progressive rehabilitation exercises

In addition to conventional aerobic exercises such as walking, jogging, and cycling, as well as exercises for daily life activities such as dressing, combing hair, and climbing walls, domestic and foreign researchers have also designed a series of rehabilitation exercises based on the special circumstances of breast cancer patients, which usually comply with certain principles: that is, keep the shoulder joint immobilized within 24 hours after surgery to prevent postoperative bleeding and subcutaneous effusion; from the first day after surgery to the period of axillary negative pressure drainage (usually about 7 days), focus on the movement of the fingers, wrists, and elbow joints, avoid large-scale shoulder abduction movements, do not use the affected limb to support getting up, and do not flex or extend the body too much; from the eighth day after surgery to two weeks after surgery, the patient is generally still in the hospital, and focus on shoulder joint activities to prevent scar adhesion; within three months after surgery is the critical time for functional exercise. Regular and sufficient exercise during this period can prevent intra-articular adhesion caused by long-term joint immobilization, promote the formation of loose connective tissue under scar tissue, expand the range of motion of the upper limbs, and shorten the time for upper limb function recovery.