PHYSIOTHERAPY AFTER SURGERY FOR BREAST-CA NCER

We have compared different modes of rehabilitation after breast cancer surgery a population of 257 patients treated at the Institut Gustave- Roussy in 1990 and 1991. The made of rehabilitation was randomized acc ording to a 2x2 design, between physiotherapy alone, shoulder movement alone, both or neither Treatment began the day after breast surgery a nd continued for 7 days. Afterwards, all patients had physiotherapy an d shoulder movements until the end of hospitalisation. Treatment effic acy was evaluated at day 7 by the volume of lymph drained and by degre e of shoulder movement. The volume of lymph collected by day 7 was red uced in the physiotherapy groups, but was ndt modified in the groups w ith shoulder movement. The degree of motion was larger in the group wh o had had both physiotherapy and shoulder movement: The frequencies of complications at day 7 and later were similar in the Sour treatment g roups, but locoregional pain was less frequent in the two groups with shoulder movement than in the two other groups. An early treatment inc luding both physiotherapy and shoulder movement seems advisable.