Proposal for physiotherapeutic intervention in painful ghost mama syndrome for women with mastectomy due to breast cancer

Abstract

Introduction: In breast cancer is one of the most frequent in women, it brings with it several complications after treatment. one of them is painful ghost breast syndrome (PGBS), which is the subjective experience of perceiving and detecting the presence of all or part of the breast accompanied by pain. In Costa Rica, there is no protocol or guide for the physiotherapeutic approach in women with PPBS. Objective: To establish the pathophysiological characteristics of the PPBS to achieve its understanding and thus prepare a proposal for physiotherapeutic intervention based on the effects of physical agents on the body. Materials and methods: Descriptive study of bibliographic review, considering digital resources such as PubMed, LILACS, Scielo, Elsevier, RefSeek, Google Scholar, Dialnet, Academia, Base, Springer Link, ERIC and Redalyc as sources, using the words neoplasm of breast AND mastectomy OR syndrome of ghost limb OR pain AND physiotherapy OR rehabilitation. Documents published from 1990 to 2020 are included, in Spanish, English and Portuguese. Based on the published evidence, physiotherapeutic intervention algorithms are proposed in women with PPBS. Results: A physiotherapeutic intervention proposal for PGBS is elaborated, based on the theories found that show the cause, symptoms and signs of the syndrome. Physiotherapeutic modalities are established with evidence and scientific support that can be safely used under professional judgment and knowledge to address PGBS or similar syndromes such as phantom pain. TENS, superficial thermotherapy and cryotherapy are established as physiotherapeutic techniques to treat pain; in addition some manual techniques such as Trigger Point Release, therapeutic massage and neurodynamics to treat myofascial and nervous tissue affected by the surgery; in addition to the use of neuromuscular bandage to improve the affected mechano-sensitivity in women with this GPBS. Conclusion: Physiotherapists with knowledge in oncological rehabilitation can generate great contributions in the health and quality of life of women with GPBS, using physiotherapy based in evidence.