Is immediate reconstruction after mastectomy in breast cancer patients beneficial to shoulder function?
- Is immediate reconstruction after mastectomy in breast cancer patients beneficial to shoulder function?
- breast cancer; breast reconstruction; scapula tilting; shoulder and arm morbidity; transverse rectus abdominis myocutaneous flap
- Issue Date
- ANZ JOURNAL OF SURGERY, v. 88. no. 4, page. 363-368
- Background: To compare shoulder morbidity between patients who received transverse rectus abdominis myocutaneous (TRAM) flaps after mastectomy (MX + TRAM) and patients who underwent mastectomy only (MX).
Methods: Thirty patients in each group were followed for a minimum of 2 postoperative years. Visual analog scale (VAS) score, restricted range of motion (ROM), rotator cuff disease, muscle strength, shoulder function scores (American Shoulder and Elbow Score and Shoulder Pain and Disability Index), measurement of scapular tilt on chest radiography and standing position in each group were compared.
Results: There were no significant differences in VAS, restricted ROM, rotator cuff disease, 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 versus 7.8 9.1 mm; P = 0.001) were significantly different between the two groups.
Conclusions: Immediate breast reconstruction after a MX had advantages for preserving scapular resting alignment but did not provide benefits for shoulder morbidity on short-term follow-up.
- 1445-1433; 1445-2197
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