Pilot Project Results
The pilot study included 14 women. Half were in the intervention and half were in the control group. Their ages ranged from 36 to 66 with a mean of 53.2. All the participants had diagnosis of breast cancer. Half had a lumpectomy or partial mastectomy with axillary node dissection, 2 had a total mastectomy and axillary node dissection, 3 had axillary node dissection alone, and 1 reported other.
T-tests were performed on pain scales, level of disability, and range of motion. Although none of the t-tests had statistically significant results, some interesting trends were noted. One post-operative day 1, the intervention group reported a lower average level on pain than the control group. The intervention group reported an average of 2 massages from their significant other on post-operative day 1. With respect to the disability measures, the intervention group reported a lower level of difficulty with all tasks at the first follow up compared to the control group. At the third follow-up, the intervention group continued to experience less difficulty with putting a pullover undershirt or sweater tan the control group. The intervention group also reported less difficulty with placing an object on a high shelf then the control group. On range of motion measurements at the third follow-up, the intervention group had less forward flexion mobility than the control group. However, the intervention group did demonstrate greater mobility in abductions than the control; the intervention group had greater internal rotation mobility than the control; and the intervention group had greater external rotation mobility than the control group. Despite the lack of statistical significance of the t-tests, findings demonstrate notable trends between the intervention and control groups.
Although the small size precludes generalizations, those in the intervention group report satisfaction with the intervention. Woman in the intervention group used both prescribed medication and massage to cope with pain. The pain relief massage provided in the initial 24 hours ranged from 0% to 70% compared to relief from medication of 0% to 100%. Over the next days, the relief from massage was 70% (range 60-80), and the average pain relied from medication was 72.5% (range 60-85).
Findings are limited by the small sample size of the pilot study, indicating a need for the larger study in order to further investigate the effects of post-operative arm massage with breast cancer patients, although we have been encouraged by the trends noted.
The majority of studies completed by both physiotherapy and nursing describe chronic management of lymphedema and ongoing range of motion difficulties. The notion of health prevention and recommendations for the need to study alternate prevention strategies has been suggested. An opportunity to explore the effects of the addition of massage therapy in the early post-operative period following breast related surgery exists. The effect of the addition of massage to usual exercise program is another area of interest. Furthermore, teaching the significant other the simple massage technique may provide a tangible helping role that traditionally has not existed. The initial pilot results have encouraged us to study this matter further.