The rehabilitation of breast cancer patients includes the recovery of physical function, adjustment of psychological state and recovery of social activity ability.
I. Rehabilitation of the affected limb function
1. Functional exercise: (1) 1-2 days after surgery, practice fist clenching, finger extension and wrist flexion; (2) 3-4 days after surgery, forearm extension and flexion; (3) 5-7 days after surgery, touch the opposite shoulder and ipsilateral ear with the affected hand (the affected limb can be supported by the healthy limb); (4) 8-10 days after surgery, practice shoulder joint elevation, extension and flexion to 90°; (5) 10 days after surgery, shoulder joint climbing wall and apparatus exercise.
The requirement for functional exercise was that the upper arm on the affected side could be straightened and raised around the top of the head to touch the opposite ear within 2 weeks. The functional exercise should be continued after the standard is achieved. Shoulder abduction is limited for 7 days after surgery. In cases of severe flap necrosis, avoid significant exercise for 2 weeks after surgery. If the subcutaneous fluid accumulation or drainage exceeds 50 mL 1 week after surgery, the number of exercises and the range of shoulder movement should be reduced (restriction of abduction). Shoulder exercises should be postponed after skin grafting and breast reconstruction with latissimus dorsi flap.
2. Prevention or reduction of upper limb edema: Generally, it is considered that the circumference of the affected upper limb is <3 5="">5 cm longer than the circumference of the contralateral upper limb as severe edema. Specific approaches.
(1) Prevent infection: keep the skin on the affected side clean; do not perform invasive operations on the affected arm, such as blood draws and infusions; wear loose gloves when washing to avoid prolonged contact with irritating washing solutions; avoid mosquito bites; always dress and wear jewelry or watches loosely. Wear elastic cuffs when traveling by airplane.
(2) Avoid hot environment: avoid burns; do not apply hot compresses to the affected arm and do not overheat the water when bathing; avoid bright light exposure.
(3) Avoid weight bearing: avoid lifting, pulling or pushing heavy objects; avoid heavy physical labor or more strenuous physical activities.
II. Diet and nutrition
There is no evidence to prove that a certain type of food and diet is associated with the recurrence or metastasis of breast cancer. A diet rich in fruits, vegetables, coarse grains and soy products is recommended. Adults should drink at least 2 to 3 glasses of vegetable juice and 1 to 2 glasses of fruit juice daily. Dietary supplements (e.g. multivitamins) are not recommended. Placenta and its products and health supplements of unknown ingredients are contraindicated.
III. Exercise
At least 150 min of moderate intensity exercise per week and strength training 2 times a week. Such as brisk walking, cycling, swimming, tai chi and aerobic dance.
IV. Establish a healthy lifestyle
(1) Maintain a normal body weight.
(2) Adhere to exercise routine.
(3) Reduce the intake of alcohol and do not smoke; use health care products carefully.
V. Sexual rehabilitation guidance
The sex hormone that causes women to have sex drive is estrogen. Women only need a very small amount of estrogen to maintain the normal level needed for sexual desire.
(1) Improve communication with your partner about your sex life.
(2) Try sensual massage and increase sexual fantasies. Share your sexual fantasies with your partner.
(3) Read a good book on sex to increase your knowledge and skills about sex.
(4) Encourage your partner to be more active in sexual activities.
(5) Tell your partner to do it in the way you like.
Sixth, fertility guidance
Fertility may be considered in the following cases.
(1) Patients with carcinoma in situ of the breast after surgery and radiotherapy.
(2) 2 years after surgery for patients with lymph node negative invasive carcinoma of the breast.
(3) 5 years after surgery for patients with lymph node-positive invasive carcinoma of the breast.
(4) Patients who require adjuvant endocrine therapy, discontinue endocrine therapy (e.g. norethindrone, triamcinolone or other SERMs) 3 months prior to conception until the end of breastfeeding after childbirth, and then continue endocrine therapy.
VII. Postoperative follow-up.
Follow-up period: every 3 months in the 1st to 2nd year after surgery (or after finishing adjuvant chemotherapy), every 4 to 6 months in the 3rd to 4th year, and once or twice a year starting in the 5th year.