Application of manual lymphatic drainage in breast surgery

Abstract

Karcinom dojke jedan je od najčešćih oblika malignih tumora kod žena i predstavlja ozbiljan javnozdravstveni problem širom svijeta. Dijagnoza karcinoma dojke ni jednoj ženi ne pada olako te otkrivanje karcinoma dojke utječe na fizičko i psihičko stanje svake pacijentice. Postoji nekoliko čimbenika koji mogu utjecati na razvoj karcinoma dojke, ali točan uzrok nije poznat. Najčešći je čimbenik pozitivna obiteljska anamneza. Pravovremena dijagnoza i liječenje ključni su za poboljšanje ishoda i smanjenje smrtnosti. Standardni dijagnostički postupak za otkrivanje karcinoma dojke je mamografija dok liječenje karcinoma dojke ovisi o stadiju bolesti, vrsti tumora i općem stanju pacijentice, a usmjereno je na tretiranje simptoma bolesti kao što su bol, umor, opća i mišićna slabost, promjene u posturi i kretanju, a uz sve fizičke simptome javljaju se i psihološki problemi. Za uspješno liječenje potrebno je oformiti multidisciplinarni tim koji se sastoji od kirurga , onkologa, radioterapeuta, med. sestre, fizioterapeuta , psihologa , psihijatra. Fizioterapija igra značajnu ulogu u vraćanju funkcionalnosti, smanjenju boli i poboljšanju kvalitete života nakon operacijskih i terapijskih postupaka stoga je ključno da se sa fizioterapijskim postupcima krene neposredno nakon operacije. Jedan od tih fizioterapijskih postupaka je i limfna drenaža. Nakon mastektomije, uklanjanjem dojke i često okolnih limfnih čvorova dolazi do poremećaja u limfnoj cirkulaciji, što može rezultirati limfedemom. Limfna drenaža pomaže u smanjenju otoka, poboljšanju protoka limfe i prevenciji komplikacija povezanih s operacijom dojke. Uz sve fizioterapijske postupke fizioterapeut je dužan osposobiti i pripremiti pacijenticu za provođenje mjera samozbrinjavanja radi bržeg i optimalnijeg oporavka.Breast cancer is one of the most common forms of malignant tumors in women and represents a serious public health problem worldwide. The diagnosis of breast cancer does not come lightly to any woman, and the discovery of breast cancer affects the physical and psychological state of each patient. There are several factors that can influence the development of breast cancer, but the exact cause is not known. The most common factor is a positive family history. Timely diagnosis and treatment are key to improving outcomes and reducing mortality. The standard diagnostic procedure for detecting breast cancer is mammography, while the treatment of breast cancer depends on the stage of the disease, the type of tumor and the general condition of the patient, and is aimed at treating the symptoms of the disease such as pain, fatigue, general and muscular weakness, changes in posture and movement, and in addition to all the physical symptoms, psychological problems also occur. For successful treatment, it is necessary to form a multidisciplinary team consisting of a surgeon, oncologist, radiation therapist, nurse, physiotherapist, psychologist, psychiatrist. Physiotherapy plays an important role in restoring functionality, reducing pain and improving the quality of life after surgical and therapeutic procedures, therefore it is crucial to start physiotherapy procedures immediately after surgery. One of these physiotherapy procedures is lymphatic drainage. After a mastectomy, the removal of the breast and often surrounding lymph nodes disrupts lymphatic circulation, which can result in lymphedema. Lymphatic drainage helps reduce swelling, improve lymph flow, and prevent complications associated with breast surgery. Along with all physiotherapy procedures, the physiotherapist is responsible for training and preparing the patient to implement self-care measures for a faster and more optimal recovery