Influence of seroma and phantom breast on postural balance control in women after breast cancer surgery

Abstract

Introduction: Current treatments for breast cancer, despite promoting improvements in cancer pathology, also generate adverse symptoms, such as the occurrence of seromas and the presence of phantom breast sensation. In addition, functional impairments, such as changes in postural control, are common in these patients. However, the influence of certain symptoms on the postural control of this population is still unclear. Objective: The aim of the present study was to investigate the influence of seroma and phantom breast sensation in the postural control of post-mastectomy-plus-adjuvant treatment patients. Methods: Thirty-five patients participated in the study. Data on pre- and post-treatment symptoms were collected, including the record of the presence of seroma and phantom breast sensation. The participants were also subjected to a posturographic test, in which they should be positioned on a force platform with the feet apart from each other with their eyes open or closed. The standard deviation and the mean velocity of postural displacement in the anterior-posterior and medial-lateral directions were computed. Two-way ANOVA was applied, assuming alpha of 5%. Results: Patients were allocated to a positive (N=18) or negative (N=17) seroma group; considering the phantom breast sensation, those same patients were divided into a group with (N=20) or without (N=15) such manifestation. We observed statistical differences between the positive versus negative seroma groups for mean velocity of postural displacement in the anterior-posterior direction (P=0.031), corresponding to the slower postural displacement in the positive seroma group. There were significant differences between visual conditions, for all variables, regardless of the group, reflecting the reduction in postural displacement descriptors in the closed eyes condition. Conclusion: Postural control is altered in patients undergoing treatment for breast cancer who have seroma, but not when reporting a phantom breast sensation. The patients' response to the closed eyes condition indicates a change in the sensory integration underlying postural control in this population.