Track 22: Breast Cancer: Case Study:-
Breast Cancer Personalities of the patient:-
- A women
- 58-year-old
- Work as a teacher in elementary school
- With a shoulder discomfort complaint during direct access
- High blood pressure and inactivity are co-morbidities.
- Previous Medical History: The patient mentions a rotator cuff repair.
- Family history of hypertension, diabetes, mother’s death from breast cancer, and hypothyroidism
- Prior medical attention or treatment: The patient underwent physical therapy after a right rotator cuff repair five years ago.
Examination:-
The patient recalls a sneaky onset of right shoulder discomfort that started around three months ago. According to the patient, their pain is a 6 out of 10, with a 3 being their highest rating. At least three times each week, the patient reports being awakened by a profound aching in the night. The patient complains of shoulder discomfort making it difficult to do self-care tasks such as showering, grooming, and clothing. The patient adds that during the last month, she has accidentally lost weight, which she blames for increasing work-related stress.
Quick DASH – 29.5 per cent on the self-report outcome measures scale.
- Objective
- The palpation revealed no pain.
- ROM
- PROM: Painless with end-range abduction within the functional limit (WFL)
- R shoulder flexion: 1100 AROM (pt reported pain)
- Shoulder flexion to the right: 1120 (pt reported pain)
- Muscle testing manually (MMT)
- Shoulder flexion, right/left: 4/5
- R/L shoulder flexion: 4.5/5
- Shoulder extension, right/left: 4/5
- R/L shoulder IR: 4-5
- R/L shoulder ER: 4.5
- 5/5 R/L Elbow Flexion
- R/L Elbow Expansion: 5.0/5
- 5/5 on the R/L wrist extension
- Flexion of the R/L wrist: 5/5
- WFL R/L Supination
- WFL R/L Pronation
- Grip Strength: WFL R/L
- WFL R/L Sensory
- R/L Reactions: WFL
Clinician’s Impressions:-
The patient, a 58-year-old female, complains of a right shoulder ache when she arrives at the clinic. The patient was encouraged to visit their primary care physician again for additional medical testing in light of their age, family history, and subjective report. This patient’s age of 58 makes her a candidate for breast cancer due to her gender. A direct family who just passed away from breast cancer is another risk factor this patient has. This patient’s reports of nighttime discomfort that is so acute it wakes her up are a serious worry. Because neoplasms are accompanied by variations in hormone levels at night, this is a warning sign that a tumour may be present. Additionally, the unexplained weight loss raises doubts about a musculoskeletal rather than a more systemic aetiology.
Examination Results Summary:-
The patient describes deep, excruciating pain that wakes her up at night, as well as diminished strength and range of motion (ROM), which are not consistent with musculoskeletal reasons. The physical therapist’s evaluation is unable to duplicate the patient’s precise complaints.
Intervention:-
- With a stage 2 breast cancer diagnosis from the doctor, the patient had follow-up physical therapy. Given the patient’s family history of breast cancer, the doctor did a clinical breast exam before ordering mammography.
- Despite not having migrated to the lymph nodes or other nearby organs, the tumour was discovered in the R breast tissue. MD advises continuing surgical therapy to remove the tumour by a mastectomy. For the purpose of managing wound care, edoema, and functional restrictions, the MD has issued written instructions for post-op PT.
- In order to guarantee that aberrant cell development has been stopped, the MD additionally asks for several rounds of radiation (5 days per week for 5 weeks) (SGK). The patient and their caretaker were informed of the potential adverse effects of radiation therapy, such as skin irritability, redness, discomfort, swelling, exhaustion, and lymphedema4.
- The patient was instructed to seek outpatient physical therapy after being discharged from acute physiotherapy, where they received functional training and treatment for their lymphedema. The patient was told to keep up their physical activity after finishing outpatient physiotherapy by joining fitness classes or participating in community activities. The patient also received information on support groups.
Outcomes:-
- Most recent mammography results revealed no evidence of abnormal cell development in L breast tissue following completion of surgery and radiation therapy. The patient has recently started going to her neighbourhood gym for cycling classes, weight training, yoga, and Pilates.
- Through the hospital where she had treatment, she has also been going to support groups for breast cancer. The patient claims that she feels that exercise has made a significant difference in her rehabilitation. She has a greater sense of control over her life and health.
- She feels really motivated and energetic after the workout courses. Her participation in the support group gives her a sense of belonging and reassurance that she is not fighting this battle alone.
Post-Physiotherapy Results Metrics: 10.0 per cent for Quick DASH:-- Objective: Examination of the body
- Palpation: Only little discomfort is felt at the incision sites.
- PROM: Pain-free, WFL AROM: Shoulder flexion in R: 1500 (no reported pain)
- 1500 R shoulder flexion (no reported pain)
- MMT
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Subtopics of Breast Cancer: Case Study:-
- Breast Cancer Case Study – Physiopedia
- What is the best case scenario for breast cancer?
- Why does breast cancer happen?
- What is the most common cause of death in breast cancer patients?
- What emotion causes breast cancer
- Breast Care: 5. Cancer of the breast – Bettercar
- Cancer Centers In Usa – Breast Cancer Articles
- Breast cancer case study pdf
Track 22: Breast Cancer: Case Study:-
Be Aware:-
Each year, more than 1.5 million new instances of breast cancer are recorded globally, and 60% of these cases are HR-positive.
The majority of treatment for advanced breast malignancies has been hormone therapy; nevertheless, resistance to hormonal therapy inevitably arises, which has sparked a growing interest in modifying the causes of resistance.
Promising treatments for advanced, HR-positive, HER2-negative breast cancer include CDK 4/6 inhibitors like palbociclib, ribociclib, and abemaciclib.