383 Photobiomodulation and manual lymph drainage for nipple necrosis treatment in breast cancer: a case report

Objectives Recently, breast reconstruction after mastectomy with nipple preservation became an option of breast cancer surgery. Despite its efficacy and aesthetic superiority, the nipple preservation is associated with several complications in the postoperative period.The photobiomodulation therapy, formerly known as low-intensity laser therapy, demonstrated tissue promotion repair by cellular repair biostimulation, angiogenesis and anti-inflammatory effects. These characteristics suggest a potential role for repair of chronic wounds and may be applicable in necrosis treatment. Our aim was to report the effects of the physiotherapeutic intervention through photobiomodulation therapy in a patient with nipple necrosis after risk reducing mastectomy. Methods We report a case of a breast cancer surgery with nipple necrosis treated with low-level laser therapy. The patient was a 36-year-old women who developed skin nipple necrosis in the right breast after bilateral reconstructive mastectomy. She had 6 sessions of low-level laser therapy. Results A female subject developed a nipple necrosis of more than 40% on the right breast after mastectomy and reconstruction. She was referred to Physical Therapy (PT) and the PT sessions were composed by manual lymph drainage, manual therapy for de AWS, exercises of strength and flexibility, followed by LLLT with laser 660 nm, 2 joules per point at every 1 cm. Therapy was implemented for 12 times in total, from May 2016 to June 2016. A re-evaluation was performed monthly from July 13,2016 to November 2017. After 18 months of follow-up, the sustained effects of LLLT were found. Conclusions Low-level laser therapy is effective for the skin cicatrization after nipple necrosis.