Postural alterations in breast cancer survivors: proposal of the PABS evaluation protocol based on a systematic review

INTRODUCTION: The constant improvement of the diagnostic process and the crescent efficacy of treatment options for Breast Cancer have led to an increase in the survival rate of patients. Thereby, it has become fundamental for Breast Care Units to deal with short-, medium-, and long-term sequelae of the disease and its treatment. Among these, changes in posture seem to have a crucial role. This review aims to collect and summarize the current knowledge on postural disorders in Breast Cancer Survivors, focusing on evaluation methods and rehabilitation protocols. EVIDENCE ACQUISITION: A systematic research was conducted on PubMed, Scopus and World of Science databases, considering all the studies published up to 2021. Case reports, case series, cross-sectional, retrospective and prospective studies were included. Narrative and Systematic reviews were excluded. EVIDENCE SYNTHESIS: After applying the eligibility criteria and bibliographic expansion, 55 articles were selected. Forty-four studies focused on the analysis and the quantification of postural abnormalities, showing a huge variability in population characteristics, valuative methods and outcome measures. Most of them are cross-sectional studies. Rehabilitation treatments have been considered in only 12 studies: all the rehabilitative treatments proved to be effective but, the heterogeneity among the evaluation methods has made a comparison impossible. Hence, we designed a complete evaluation protocol for the assessment of postural abnormalities in Breast Cancer Survivors. Our protocol has been drawn following the structure of International Classification of Functioning, Disability and Health. CONCLUSIONS: Our review pointed out the crescent interest of the current Literature on analysis and treatment of postural alterations in breast cancer survivors. Since the extreme variety of outcome measures made it impossible to give a clear indication for evaluation and treatment of this disorder, we designed a complete evaluation protocol for the assessment of postural abnormalities in breast cancer survivors, with the goal of guiding the design of new clinical trials on these subjects.