Effect of Myofascial Therapy After Surgery and Radiotherapy in Breast Cancer Treatment

Purpose: Many women experience physical late effects after surgery and radiotherapy as part of breast cancer treatment and need physiotherapy. Myofascial therapy is a commonly used treatment for these late effects, though scientific evidence is limited. This systematic review aimed to evaluate and summarize the existing research on the effects of myofascial therapy on physical late effects after breast cancer treatment with surgery and radiotherapy. Method: Systematic literature searches for randomized controlled trials investigating the effect of myofascial therapy on late effects after breast cancer were conducted in the databases Amed, Embase, Cinahl, Medline, PEDro, and Pubmed on February 27th, 2020, and February 6th, 2023. The Cochrane Collaboration ́s tool for assessing risk of bias (RoB) was used. Meta-analyses of outcome measures on shoulder abduction and flexion (degrees), shoulder function (Disabilities of the Arm, Shoulder and Hand questionnaire, 0-100), and pain (log-transformed visual analogue scale, 0-100) were conducted to estimate mean differences with 95% confidence intervals (CIs). Results: 233 studies were identified, of which five were included in the meta-analyses with 245 participants. Myofascial therapy improved shoulder abduction immediately after intervention (13.0; 6.3 to 19.6; p=0.001) and at last follow-up (10.4; 3.0 to 17.8; p=0.006), improved shoulder function at last follow up (-5.8; -10.7 to -1.0; p=0.020), and reduced pain intensity at last follow up (-0.33; -0.54 to -0.12; p=0.003). Conclusion: This review indicates that myofascial therapy can have positive impact on late effects after breast cancer treatment regarding, shoulder abduction, shoulder function, and pain. More studies are needed to compare myofascial therapy with relevant alternative interventions, as well as investigating long-term effects, timing, frequency and duration of myofascial therapy, and other outcomes such as quality of life.