usc Breast Center
Meet Our Physical Therapy Team
Your physician may request a Physical Therapy “pre-surgical screening evaluation”. This is an important procedure as the physical therapist will gather baseline information regarding your present physical status which will assist the therapist in designing an individualized treatment program after your breast cancer surgery.
The Physical Therapy pre surgical screening evaluation may include any of the following:
- Postural assessment
- Range of motion measurements
- Strength measurements
- Balance and gait
- Arm girth and volumetric measurements
- Determination of your activity level, goals and work related physical demands
- Education information will be discussed regarding
- What to expect after surgery
- Pre- and Post-Surgical Exercises
- Lymphedema Precautions and Risk Reduction
Post-Surgical Physical Therapy Interventions
1. Post-Surgical Effects
- Soft-tissue adhesions and scarring
- Post surgical swelling
- Impaired neck, shoulder and scapulae mobility
- Decreased upper extremity strength, endurance and function
- Cardiovascular deconditioning
- Myocutaneous Flaps (TRAM, Latissimus Dorsi and Gluteus): Rehabilitation focuses on complications at both the chest wall and donor sites. Complications may include scar tissue adhesions, decreased mobility/range of motion, decreased strength, and cardiovascular deconditioning that interferes with a woman's ability to perform activities of daily living with ease and without pain.
- Implants: Rehabilitation focuses on reducing scar tissue formation around the implant and increasing flexibility and strength around the shoulder joint in order to maximize the functional use of the arm.
3. Lymphedema Management
Patients diagnosed with Lymphedema will be evaluated in order to determine the appropriate course of treatment, and may include the following:
All patients who have had surgery involving removal of axillary lymph nodes or sentinal node biopsy are educated about the possibility of developing this condition. Patients are instructed in Lymphedema precautions in order to minimize the risk of its development.
Post-Mastectomy/Sentinel Node Biopsy Lymphedema
Breast Cancer Lymphedema treatment focuses on reducing the swelling that occurs in the hand, arm, neck or chest wall. Lymphedema develops as a result of lymph vessel or lymph node damaged due to surgery or radiation, scar tissue formation or remove during the axillary lymph node dissection or sentinal node biopsy.
Lymphedema is a challenging condition; however with therapy and a home program, it can be effectively managed. Treatment can improve your quality of life and assist you in returning to your home, work and social physical activities.
Lymphedema Treatment and Therapeutic Procedures
While it is not usually possible to repair the damage done to the lymphatic system, it is possible to move lymph fluid from the affected region to an area where the lymphatics are working normally. The fluid can then be drained back to the bloodstream.
- Manual Lymph Drainage mobilizations to stimulate lymph drainage and reduce swelling
- Multi-layered compression bandaging or compression braces to control edema reduction obtained with lymph drainage mobilizations and promote further edema reduction
- Exercise to maximize lymph drainage
- Skin care to maintain a healthy skin condition and reduce the risk of infection
- Referral for fitting of a medical compression garment to maintain edema reduction
- Education to teach patient and family members a lymphedema management home program.
- If indicated, use of a specialized lymphedema pump.
Patient Education Materials
USC DEPARTMENT OF SURGERY
BREAST CENTER PHYSICAL THERAPY
1640 Marengo Street, HRA 102
Los Angeles, CA 90033-1036