Correction of comorbidity as part of the pre-rehabilitation of breast cancer patients

Abstract

The purpose of the study is to analyze the frequency of early postoperative complications and their dependence on the comorbid status of patients with breast cancer (BC). A retrospective analysis of the medical records of 1938 women with I-IIIB st. BC (mean age – 50.8 years), whose treatment began with the Halsted, Patey, Madden radical mastectomy or radical resection. The entire cohort of patients had early postoperative complications including long-term lymphorrhea (26.1%), wound suppuration (8.9%), suture line disruption (7.2%), plexitis (7.3%), bleeding (1%). There was no statistically significant difference in the frequency of these complications depending on the type of operation. Comorbid conditions were diagnosed in 97.5% of patients. The main ones were the following: cardiovascular diseases (36.2%), metabolic diseases (10.2%), and kidney diseases (6.3%). In a paired comparison of the frequency of cases of wound suppuration and suture line disruption in groups of patients (with any type of operation) with the main comorbid conditions with a control group (without diseases), no statistically significant difference was found (p = 0.111), as well as for plexitis (p=0.414). In the case of small groups of patients with bleeding, it was not possible to use the criterion for comparison. As for the increase in the frequency of long-term lymphorrhea, statistically significant differences related to the type of surgery were obtained for patients with cardiovascular diseases (p=0.0013), metabolic diseases (p = 0.011), and kidney diseases (p = 0.034). Thus, prerehabilitation should include correction of the comorbid status of BC patients, which will significantly reduce the frequency of long-term lymphorrhea, thereby reducing the course of the postoperative period and bringing the start of adjuvant therapy closer.