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presented by Linda T. Miller, PT, DPT, CLT
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
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This course will focus on the complications and post-operative sequelae of surgical intervention for breast cancer. The details of the axillary dissection, including its purpose and impact on rehabilitation, will be examined, with a focus on post-operative cording and the potential resultant impact on scapular musculature. This course will also review current breast reconstruction procedures and their physical impact on recovery and function. Specific rehabilitation interventions and timelines will be presented.
Linda T. Miller, PT, DPT, CLT
Linda T. Miller, PT, DPT, CLT, served as the founder and clinical director of the Breast Cancer Physical Therapy Center in the Philadelphia area for over 20 years. She has over 300 hours of training in lymphedema management and has been an international student of lymphedema, including training in the UK, Italy, Spain, France, and…
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1. The Axillary Dissection
Given the number of new breast cancer diagnoses every year, clinicians in various settings should be familiar with the morbidities that directly result from the axillary dissection performed with most invasive breast cancers. It is this procedure that causes most of the post-operative pain, decreased UE ROM, and impact on immediate function. Identification of some of these morbidities will be discussed.
2. Post-Operative Cording
Post-operative cording is a common, acute consequence of the axillary dissection that can be managed successfully when identified early. Cording, sometimes with forearm and hand swelling, can occur months or years following surgery. Identifying the cords and treating them with modalities and manual therapy can prevent this from becoming a chronic source of pain and edema.
3. Muscle and Postural Imbalances
Several motor nerves course through the area of the axillary dissection and are at risk for trauma during the procedure. Therapists treating this population of patients should be aware of the possible consequences on specific UE muscle function.
4. Breast Cancer Reconstruction
Reconstruction following mastectomy will impact the rehabilitation process. The various options currently available will be presented.
5. Rehabilitation Following Breast Cancer Reconstruction
The immediate and long-term effects of reconstruction techniques will be described. Providing a comprehensive rehabilitation program and insuring a return to full function will be discussed.
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