Breast cancer is a serious health issue affecting millions globally. It occurs when malignant tumours form in the breast tissue, growing uncontrollably. The statistics surrounding breast cancer are staggering, with 29% of all new cancer cases in Australian women being breast cancer. While often associated with women, it can also affect men—around 144 men in Australia are expected to be diagnosed this year. The lifetime risk for women to develop breast cancer by the age of 85 is 1 in 8, while for men, it’s 1 in 631.
Risk Factors for Breast Cancer
Several risk factors can increase the likelihood of developing breast cancer. These include:
- Age and Race: White women and those aged around 60 have a higher risk.
- Height: For every 5 cm increase in height, the risk increases by about 10%.
- Reproductive Factors: Women who experience early menstruation (before age 12), late menopause (after age 55), or have their first pregnancy after age 30 have a heightened risk.
- Weight Gain and Alcohol Consumption: Increased body fat, particularly in the abdomen, and consuming more than one alcoholic drink per day also raise the risk.
- Low Vitamin D Levels: Deficiency in vitamin D has been associated with an increased risk.
Early Detection and Screening
Early detection is key to improving outcomes. Regular screenings using mammography, palpation, and molecular breast imaging can help identify breast cancer in its early stages. For women aged 20-40, screenings are recommended every 2-3 years, while women over 40 should have annual check-ups.
Stages of Breast Cancer
Breast cancer is classified into several stages based on tumour size, lymph node involvement, and whether the cancer has spread to other parts of the body:
- Stage 0: Non-invasive cancer, such as ductal carcinoma in situ (DCIS).
- Stage I: A small tumour (≤2 cm) with little or no lymph node involvement.
- Stage II: Larger tumours (2-5 cm) or some lymph node involvement.
- Stage III: Locally advanced cancer, often affecting several lymph nodes or the chest wall.
- Stage IV: Metastatic cancer, where the cancer has spread to distant organs like the liver, bones, or brain.
Treatment Options
Treatment for breast cancer depends on various factors such as the cancer stage, type, hormone receptor status, and the patient’s age and overall health. Some common treatment modalities include:
- Chemotherapy: A systemic treatment that targets cancer cells throughout the body, often used in various stages.
- Radiation Therapy: Used after surgery to eliminate any remaining cancer cells in the breast or nearby areas.
- Hormonal Therapy: For hormone receptor-positive cancers, this therapy blocks the effect of hormones like estrogen on cancer cells.
- Surgery: This can include breast-conserving surgery, mastectomy (removal of the breast), and lymph node removal. Reconstructive options, such as using silicone implants or tissue flaps (like TRAM or Latissimus Dorsi), are also available.
Impact of Surgery on Physical Function
Breast cancer surgeries, especially those involving tissue reconstruction, can have significant effects on physical function and strength, particularly in the abdominal or upper body muscles.
- TRAM Flap Procedure: Involves using tissue from the rectus abdominis muscle, which can compromise abdominal strength. Patients should avoid core-intensive exercises like sit-ups or planks during recovery. Physical therapy will focus on gentle exercises to regain core stability.
- Latissimus Dorsi Flap Procedure: This surgery uses tissue from the latissimus dorsi muscle in the back, which can result in weakened upper body strength. Recovery will require avoiding exercises like pull-ups or heavy lifting until the muscles recover.
Additionally, breast cancer surgeries often lead to reduced shoulder range of motion (ROM), poor scapular stability, and posture changes. Rehabilitation focuses on restoring movement and preventing complications such as frozen shoulder or scapular winging, which can occur after surgery or radiation.
Common Post-Surgical Complications
Axillary Web Syndrome (Cording): Tight, rope-like structures under the skin can limit shoulder and arm movement after surgery. Treatment includes stretching exercises, myofascial release, and lymphatic drainage therapy to reduce tension.
Lymphedema: Swelling in the arm, hand, or chest due to lymph node removal can lead to reduced mobility. Gentle exercises, aquatic therapy, and lymphatic care can help manage this condition and prevent worsening.
Physical Activity and Breast Cancer Recovery
Physical activity plays a crucial role in both prevention and recovery from breast cancer. Studies have shown that regular exercise can:
- Reduce the risk of developing breast cancer.
- Decrease cancer-related fatigue, especially in patients undergoing chemotherapy.
- Improve overall quality of life by reducing symptoms in the breast and arm.
- Increase shoulder mobility and reduce the risk of lymphedema.
Despite these benefits, exercising during cancer treatment comes with challenges. Increased fatigue, radiation burns, and immune system concerns can make physical activity difficult. It’s essential to work closely with healthcare professionals to find a balance that supports recovery without causing additional strain.
Conclusion
Breast cancer is a complex disease, but early detection, personalized treatment, and a strong focus on rehabilitation can significantly improve outcomes. For those affected, physical therapy plays a vital role in regaining strength and mobility, enhancing recovery, and improving quality of life. By understanding the risks, treatment options, and the importance of physical activity, patients and their loved ones can navigate the journey of breast cancer with greater confidence.
