Common long-term and late effects of breast cancer treatment^[1]

Effect	Management options
Surgical
Cosmetic effects	Plastic surgery
Functional disability of arm or chest wall, pain	Physical therapy
Scarring/adhesions	Plastic surgery
Lymphedema	Physical therapy, avoid trauma to involved arm*
Radiation
Second malignancies	Image masses arising near radiation field
Pneumonitis, pulmonary fibrosis	Symptomatic management
Cardiac damage	Lifestyle risk-reduction (diet, exercise, tobacco avoidance)^¶
Lymphedema	As above
Systemic therapy
Second malignancies (myelodysplasia and leukemia)	Check CBC if symptoms of leukemia arise
Ototoxicity (eg, cisplatin)	Symptomatic management
Cardiomyopathy (eg, anthracyclines)	Symptomatic management
Renal toxicity (eg, cisplatin)	Symptomatic management
Premature menopause and infertility (eg, alkylating agents)	Referral to infertility specialist
Menopausal symptoms	Gabapentin, SNRI (eg, venlafaxine), SSRI
Sexual dysfunction	Counseling, lubricants
Osteoporosis (eg, hormonal therapy, chemotherapy)	Calcium, vitamin D, exercise, bisphosphonate
Neuropathy (eg, taxanes and platinums)	Symptomatic management (eg, antidepressants, antiseizure medications for painful neuropathy)
Cognitive dysfunction	Cognitive therapy
Weight gain	Exercise and diet
Fatigue	Exercise, rule out other causes

CBC: complete blood count; SNRI: serotonin-norepinephrine reuptake inhibitors; SSRI: selective serotonin reuptake inhibitors; TSH: thyroid stimulating hormone.
* Surgical approaches are also available for management of lymphedema.
¶ Referral to a cardiologist is appropriate.

Reference:

Hayes DF. Clinical practice. Follow-up of patients with early breast cancer. N Engl J Med 2007; 356:2505.

Graphic 81721 Version 5.0

خرید پکیج

Common long-term and late effects of breast cancer treatment[1]

Common long-term and late effects of breast cancer treatment^[1]