The musculoskeletal consequences of latissmus dorsi breast reconstruction in women following mastectomy for breast cancer

Current evidence suggests that patients who have latissimus dorsi (LD) breast reconstruction following mastectomy for breast cancer can experience long-term shoulder dysfunction. However, as there is no standardised assessment or follow-up period within the literature, findings are conflicting. This...

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Bibliographic Details
Published in:PloS one 2018-08, Vol.13 (8), p.e0202859-e0202859
Main Authors: Blackburn, Nicole E, Mc Veigh, Joseph G, Mc Caughan, Eilis M, Kennedy, Richard D, McIntosh, Stuart A, Wilson, Iseult M
Format: Article
Language:English
Subjects:
Activities of daily living
Aesthetics
Aged
Biology and Life Sciences
Breast cancer
Breast Neoplasms - physiopathology
Breast Neoplasms - surgery
Breast reconstruction
Cancer
Care and treatment
Dentistry
Funding
Health care
Humans
Joint surgery
Lymphedema
Mammaplasty
Mastectomy
Mastectomy - adverse effects
Medical diagnosis
Medical personnel
Medical research
Medicine
Medicine and Health Sciences
Middle Aged
Morbidity
Nursing
Pain
Patient satisfaction
Public health
Quality of Life
Questionnaires
Rangefinding
Reconstruction
Recovery
Recovery of Function
Rehabilitation
Self image
Shoulder
Superficial Back Muscles - physiology
Surgery
Surveys and Questionnaires
Time Factors
Women's health
Womens health
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Summary:Current evidence suggests that patients who have latissimus dorsi (LD) breast reconstruction following mastectomy for breast cancer can experience long-term shoulder dysfunction. However, as there is no standardised assessment or follow-up period within the literature, findings are conflicting. This research aimed to investigate the impact on daily living of immediate and delayed LD breast reconstruction in women following mastectomy for breast cancer. Both qualitative and quantitative methods of enquiry were used. A focus group study explored the musculoskeletal consequences of surgery as perceived by the women (n = 15) and their healthcare professionals (n = 11). A questionnaire survey was administered (n = 159), including a range of outcome measures to quantify both the physical and psychosocial impact of LD breast reconstruction. Dyad interviews were also conducted in order to determine the impact of surgery on function and activities of daily living (ADL) from the woman's perspective and that of her significant other (n = 8). The qualitative studies highlighted a lack of preparedness and unrealistic expectations regarding functional recovery among women and their significant others'. Post-surgery it was apparent that women weighed up reduced shoulder function against survival, demonstrating resilience in their approach to coping with this adaptive way of living. The survey identified low to moderate effect on the outcomes assessed (n = 159), however, node removal significantly impacted certain aspects of quality of life (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0202859