Hi Mary,
I’d be concerned about possible capsular contracture as well - any history of
radiation on that side?
Thanks for sharing this case with us!
Leanna
--
Leanna Blanchard, PT, DPT, CLT, OCS, FAAOMPT
Physical Therapist and Doctor of Physical Therapy
Board Certified Specialist in Orthopaedic Physical Therapy
Fellow of the American Academy of Orthopaedic Manual Physical Therapists
Certified Lymphedema Therapist
On Oct 27, 2020, at 9:12 AM, Mary Fisher <mary.fisher@xxxxxxxxxxx> wrote:
Hello All,
Looking for insights on this case:
Patient underwent mastectomy with implant in 2004 (in another city/docs we
don't know). We saw her for the first time 2 weeks ago. She is not being
followed by any onc docs/surgeons. She complains of significant fatigue and
pain which never goes away. Pain is generalized to the breast and axillary
area, although she is quite sensitive to the touch at the lateral aspect of
the breast. Additional significant findings include a feeling of a puckered
or crinkled implant (not firm/filled). She also reports that her implant is
smaller than it used to be; she wears a prosthetic in addition to the implant
to make breasts more symmetrical. Other not significant findings include
shoulder range limited by pain but lacks any joint mobility issues; some
minor tightness issues easily addressed through PT with subsequent increased
motion; postural changes easily addressed but not impacting pain; scapular
weaknesses also being addressed.
We are very concerned about a leaking implant and have recommended she see a
plastic surgeon.
What is the best course of physical therapy treatment? I cannot find
literature that supports best interventions for this type of situation.
Thanks in advance -
Mary
Mary I. Fisher, PT, PhD | Chair and Associate Professor
Board-Certified Clinical Specialist in Orthopedic Physical Therapy
Certified Lymphedema Therapist
300 College Park | Dayton, OH 45469-2925
mary.fisher@xxxxxxxxxxx | Telephone: 937.229.5617 | Facsimile: 937.229.5601