Is immediate reconstruction after mastectomy in breast cancer patients beneficial to shoulder function?

Abstract

Background: To compare shoulder morbidity between patients who received transverserectus abdominis myocutaneous (TRAM) flaps after mastectomy (MX + TRAM) andpatients who underwent mastectomy only (MX).Methods: Thirty patients in each group were followed for a minimum of 2 postoperativeyears. Visual analog scale (VAS) score, restricted range of motion (ROM), rotator cuff dis-ease, muscle strength, shoulder function scores (American Shoulder and Elbow Score andShoulder Pain and Disability Index), measurement of scapular tilt on chest radiography andstanding position in each group were compared.Results: There were no significant differences in VAS, restricted ROM, rotator cuffdisease, muscle strength, shoulder function scores or scapula tilt on physical examination.However, lower angles of the scapula on chest radiography (4.0  13.2 versus−3.4  12.4 mm; P = 0.029) and pectoralis minor index (0.4  7.7 mm versus7.8  9.1 mm; P = 0.001) were significantly different between the two groups.Conclusions: Immediate breast reconstruction after a MX had advantages for preservingscapular resting alignment but did not provide benefits for shoulder morbidity on short-termfollow-up.