P.T Post Breast Cancer

Normal Anatomical Consideration of Breast Organ

• Breasts consist of mammary glands, connective tissue, blood vessels, nerves, and lymph vessels.
• Each breast contains 15-20 lobes, composed of lobules (milk-producing glands) and ducts (milk transport).
• The structure resembles a tree, with the nipple serving as the only exit point.
• Fatty tissue surrounds ducts and lobules, with the nipple located at the center of the areola.

Physiology and Function of the Breast

• The female breast acts as a modified apocrine gland, undergoing significant changes throughout life.
• Ductal development is stimulated by hormonal surges during puberty, preparing for lactation.
• Lactation provides essential nutrients to infants and helps space childbirth.
• Hormones such as progesterone and estrogens increase during gestation, influencing milk composition, which includes lactose, proteins, and fat.

Abnormal Breast Cancer

• Defined as a malignant tumor originating in breast cells, leading to uncontrolled growth.
• Most common cancer among Egyptian females, representing 25.5% of female cancers and 34.7% of malignancies reported at Cairo's National Cancer Institute.

Risk Factors for Breast Cancer

• Increased risk associated with age, family history, reproductive history, and lifestyle factors.
• First-degree relatives of breast cancer patients have a two- to threefold increased risk.
• Male breast cancer is rare, accounting for <1% of incidences compared to females.
• Age-adjusted incidence rises with advancing age.

Staging of Breast Cancer

• Stage I: Tumor ≤2 cm, no lymph node involvement.
• Stage II: Tumor ≤2 cm with lymph node spread or >2 cm without lymph node involvement.
• Stage IIIA: Tumor >5 cm or smaller with lymph node involvement.
• Stage IIIB: Tumor has spread to surrounding breast tissue or chest wall nodes.
• Stage IV: Distant metastasis involving other organs or lymph nodes.

Examination and Investigations for Breast Cancer

• Inspection: Conducted in four positions to check for early signs.
• Mammography: Detects >90% of breast cancers, recommended annually for women with family history post-age 40.
• Ultrasonography: Differentiates solid tumors from cystic ones and assists in biopsies.
• Biopsy: Involves tissue removal for pathology evaluation; methods include excisional, incisional, and needle biopsy.

Treatment of Breast Cancer

• Primarily involves surgery, which may be followed by chemotherapy or radiation.
• Hormone-positive cancers receive long-term hormone blocking therapy.
• Treatments vary with cancer stage; Stage I typically involves lumpectomy and minimal chemotherapy, while Stage IV requires aggressive multi-faceted approaches.
• Standard surgical options include mastectomy, quadrantectomy, and lumpectomy.

Physiotherapy Intervention After Mastectomy

• Common Impairments: Incisional pain, shoulder mobility issues, lymphedema, fatigue, and psychological impacts.
• Early Exercise Guidance: Initiate movement post-surgery, monitor swelling, and use supportive positioning.

Recommended Exercises

• Wand Exercise: Enhances shoulder mobility; involves raising a wand overhead.
• Elbow Winging: Increases front chest movement; focuses on elbow separation.
• Shoulder Blade Stretch: Promotes shoulder blade movement through sliding of the arm.
• Shoulder Blade Squeeze: Strengthens posture by closing shoulder blades without lifting shoulders.
• Side Bends: Engages trunk flexibility; involves lateral bending with arms extended overhead.
• Chest Wall Stretch: Stretches chest muscles using a wall for resistance.

This quiz covers the anatomical considerations of the breast, focusing on the composition and functions of mammary glands, connective tissue, and the lactation process. It is designed for students studying physical therapy, specifically within the context of post-breast cancer care.