THE ROLE OF A PHYSIOTHERAPIST IN THE LATE POSTOPERATIVE PHASE AFTER BREAST CANCER SURGERY

Rak dojke je najčešći maligni tumor u žena koji uzrokuje veliku smrtnost, kako u Hrvatskoj, tako i u svijetu. Razvija se kroz duži vremenski period, a liječenje i rehabilitacija veoma su kompleksni. U lokalne načine liječenja spadaju kirurška terapija i radioterapija; u sustavnu terapiju: kemoterapija, hormonalna terapija i imunoterapija, a odabir načina liječenja tumora dojke ovisi o brojnim čimbenicima. Zbog smanjene aktivnosti nakon operacije oslabljeni mišići ramenog obruča dovode do smanjenog opsega pokreta, bolnosti, te moguće pojave limfedema na ruci zahvaćene strane. Sve to dovodi do mišićne neravnoteže i posturalnih deformacija. Limfedem se najučinkovitije liječi kompletnom dekongestivnom fizioterapijom koja uključuje: manualnu limfnu drenažu, kompresivno bandažiranje, fizioterapijske vježbe, njegu kože i edukaciju. Fizioterapijski proces započinje procjenom po SOAP modelu koji obuhvaća subjektivni i objektivni pregled, evaluaciju i analizu podataka, te određivanje plana terapije.Breast cancer is the most common malignant tumor in women that causes big/great mortality, both in Croatia and in the world. It is developing over a long period of time, and treatment and rehabilitation are very complex. Local therapies include surgical therapy and radiotherapy; systemic therapy: chemotherapy, hormonal therapy and immunotherapy, and the choice of ways to treat breast cancer depends on a number of factors. Due to reduced activity after surgery, weakened shoulder muscles lead to reduced range of motion, painfulness, and possible lymphoedema on the affected side. All this results in muscular imbalances and postural deformities. Lymphoedema is most effectively treated with complete decongestive physiotherapy including: manual lymph drainage, compressive bandaging, physiotherapy exercises, skin care and education. The physiotherapeutic process begins with an assessment of the SOAP model that includes subjective and objective review, evaluation and data analysis, and determination of the therapy plan