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Is immediate reconstruction after mastectomy in breast cancer patients beneficial to shoulder function?
Author(s) -
Lee Bong Gun,
Kim Joon Kuk,
Choi Sung Hyouk,
Ahn Hee Chang,
Chung Min Sung
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13735
Subject(s) - medicine , scapula , range of motion , rotator cuff , mastectomy , visual analogue scale , breast cancer , surgery , radiography , elbow , pectoralis major muscle , shoulder joint , cancer
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.