Clinical Experience with Compression Taping to Treat Seroma After Breast Cancer Surgery: A Medical Device Clinical Study.

OBJECTIVE: To evaluate the safety of compressive taping in patients with seroma secondary to breast cancer surgery. METHODS: This study was a nonrandomized clinical study of medical devices applied to women indicated for seroma aspiration puncture after breast cancer surgery in a public reference hospital in Brazil. The intervention consisted of applying compressive taping over the seroma fluctuation area and maintained for 5 days. Evaluated outcomes comprised dermal changes caused by taping, subjective symptoms reported during the intervention period, and percent change in the punctured volume before and after the intervention. RESULTS: A total of 35 women (mean age, 56.7 ± 12.2 years) were included. Most presented with an advanced disease stage (≥IIB; 62.9%). Although a 28.6% incidence of dermal changes caused by taping was observed, an average reduction in the aspirated volume of -28.2 mL was identified (95% confidence interval, -48.3 to -8.0; P = .008). Treatment adherence was high (91.4%), and most patients reported satisfaction with the treatment (85.7%). CONCLUSIONS: The use of compressive taping on seroma areas can be considered safe, is well accepted by patients, and might be used as a noninvasive treatment option for seroma developing after breast cancer surgery.

Shoulder amplitude movement does not influence postoperative wound complications after breast cancer surgery: a randomized clinical trial.

PURPOSE: The goal of this study is to evaluate the influence of shoulder exercises with restricted amplitude movement (RAM) or free amplitude movement (FAM) performed from the first postoperative day (1st POD) on the incidence of surgical wound complications (SWC) in breast cancer. METHODS: This study comprises a randomized clinical trial with an intention-to-treat analysis including 465 women aged 18 to 79, who underwent curative surgery for breast cancer. Participants were submitted to perform free amplitude movement (FAM) or restricted amplitude movement (RAM) shoulder exercises, until the 30th postoperative day. The outcome measures were the SWC: seroma, dehiscence, necrosis, infection, hematoma and bruise. RESULTS: 461 participants completed the follow-up. Thirty days after surgery, 63.8% of the women presented some surgical wound complication, with necrosis (39.3%) and seroma (30.8%) as the most frequent. No statistically significant differences in SWC according to postoperative amplitude shoulder exercise (FAM vs RAM), even after a stratified analysis by type of surgery (segmentectomy vs mastectomy) or axillary approach (axillary lymphadenectomy versus sentinel lymph node biopsy) were observed. CONCLUSION: FAM exercises do not increase the incidence of postoperative wound complications compared to RAM exercises. TRIAL REGISTRATION: NCT03796845.

Fatores Associados ao Atraso entre o Diagnóstico e o Início do Tratamento de Câncer de Mama: um Estudo de Coorte com 204130 Casos no Brasil / Factors Associated with Delay between Diagnosis and Initiation of Breast Cancer Treatment: a Cohort Study with 204130 Cases in Brazil / Factores Asociados con el Retardo entre el Diagnóstico y el Inicio del Tratamiento del Cáncer de Mama: un Estudio de Cohorte con 204130 Casos en Brasil

Introdução: O câncer de mama é considerado um problema de saúde pública, tendo crescente incidência mundial. Diversos fatores contribuem para o diagnóstico tardio e dificultam o início do tratamento, repercutindo em um pior prognóstico. Objetivos: Analisar o intervalo de tempo entre o diagnóstico e o início do primeiro tratamento oncológico na população brasileira, além de avaliar os fatores associados aos maiores intervalos. Método: Trata-se de um estudo de coorte retrospectivo com 540.529 pacientes cadastrados no Sistema de Registros Hospitalares de Câncer (SisRHC)no período de 2000 a 2017. Utilizou-se como desfecho o intervalo de tempo entre o diagnóstico e o início do primeiro tratamento oncológico, considerando-se como atraso o intervalo maior do que 60 dias. Para análise das variáveis, foram realizadas análise descritiva e regressão logística simples (IC95%; p<0,05). Resultados: Foram analisados 204.130 casos que apresentaram média de idade de 55,8 anos (±13,24), sendo predominantemente do sexo feminino (99,1%), 55,1% eram da Região Sudeste e 71,4% residiam em cidades não capitais. A mediana do intervalo de tempo entre o diagnóstico e o início do primeiro tratamento oncológico foi de 63 dias (variação interquartil = 36-109). As variáveis sociodemográficas, clínicas e relacionadas ao tratamento mostraram impacto no intervalo de tempo, com exceção da variável sexo. Conclusão: O tempo entre o diagnóstico e o início do primeiro tratamento oncológico foi elevado. Fatores sociodemográficos, clínicos e relacionados ao tratamento influenciam nos intervalos de tempo. Identificá-los precocemente pode contribuir para o direcionamento de ações a esses grupos mais vulneráveis ao atraso.

Breast cancer is considered a public health problem with an increasing incidence worldwide. Several factors contribute to late diagnosis and hinder the initiation of the treatment, resulting in a worse prognosis. Objectives:To analyze the time interval between diagnosis and the beginning of the first oncologic treatment in the Brazilian population, in addition to assessing the factors associated with the longest time intervals. Method: Retrospective cohort study with 540,529 patients registered in the Hospital Cancer Registry System (SisRHC) from 2000 to 2017. The outcome was the time between diagnosis and the beginning of the first oncologic treatment, considering the interval greater than 60 days as delay. Descriptive analysis and simple logistic regression were performed (95% CI; p <0.05) to analyze the variables. Results: 204,130 cases were analyzed, mean age of 55.8 years (± 13.24), predominantly females (99.1%), 55.1% were from the southeast region and 71% lived in non-capital cities. The median of the time interval between diagnosis and the beginning of the first oncologic treatment was 63 days (interquartile range = 36-109). Sociodemographic, clinical and treatment-related variables affect the time interval, except the gender variable. Conclusion: The time between diagnosis and the beginning of the first oncologic treatment was high. Sociodemographic, clinical and treatment-related factors influence time intervals. Their early identification can contribute to guide the actions toward these most vulnerable groups to delay.

Introducción: El cáncer de mama se considera un problema de salud pública con una incidencia mundial creciente. Varios factores contribuyen al diagnóstico tardío y dificultan el inicio del tratamiento, resultando en un peor pronóstico. Objetivos:Analizar el intervalo de tiempo entre el diagnóstico y el comienzo del primer tratamiento oncologico en la población brasileña, además de evaluar los factores asociados con los intervalos de tiempo más largos. Método: Este es un estudio de cohorte retrospectivo con 540.529 pacientes registrados en el Hospital Cancer Registry System (SisRHC) desde 2000 hasta 2017. El resultado fue el intervalo de tiempo entre el diagnóstico y el comienzo del primer tratamiento oncologico, considerando como retraso el intervalo superior a 60 días. Para el análisis de las variables, se realizó un análisis descriptivo y una regresión logística simple (IC 95%; p <0,05). Resultados: Se analizaron 204,130 casos, con una edad media de 55,8 años (±13,24), predominantemente mujeres (99,1%), 55,1% de la región sureste y 71,4% residentes en ciudades no capitales.La mediana del intervalo de tiempo entre el diagnóstico y el comienzo del primer tratamiento contra el cáncer fue de 63 días (rango intercuartil = 36-109). Las variables sociodemográficas, clínicas y relacionadas con el tratamiento tuvieron un impacto en el intervalo de tiempo, con la excepción de la variable de género. Conclusión: El intervalo de tiempo promedio entre el diagnóstico y el comienzo del primer tratamiento oncologico fue alto. Además, se observó que los factores sociodemográficos, clínicos y relacionados con el tratamiento influyen en los intervalos de tiempo, por lo que identificarlos temprano puede contribuir a acciones directas para estos grupos más vulnerables al retraso.