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Effect of breast reconstruction modality on the development of postmastectomy shoulder morbidity

Title
Effect of breast reconstruction modality on the development of postmastectomy shoulder morbidity
Authors
Woo, Kyong-JeLee, Kyeong-TaeMun, Goo-HyunPyon, Jai-KyongBang, Sa Ik
Ewha Authors
우경제
SCOPUS Author ID
우경제scopus
Issue Date
2018
Journal Title
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
ISSN
1748-6815JCR Link

1878-0539JCR Link
Citation
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY vol. 71, no. 12, pp. 1761 - 1767
Keywords
Breast reconstructionShoulder morbidityExpander-implantLatissimus dorsi flapDeep inferior epigastric artery perforator flapRehabilitation
Publisher
ELSEVIER SCI LTD
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Background: The aim of this study was to evaluate the impact of breast reconstruction modality on the incidence of shoulder morbidity. Methods: Breast cancer patients who underwent immediate reconstructions using three modalities, namely, tissue expander-implant, latissimus dorsi (LD) pedicled flap, and deep inferior epigastric artery perforator (DIEP) flap, from 2008 to 2013 were examined. The cumulative incidence of shoulder morbidity was compared among the reconstruction modalities, and risk factor analysis was performed using multivariable analysis. Results: A total of 430 reconstructions (223 expander-implant, 44 LD flap, and 163 DIEP flap) in 420 patients were analyzed in this study. Shoulder morbidity developed in 95 patients (22.1%) and was most common in the LD group (43.2%) followed by the expander-implant (23.8%) and the DIEP (14.1%) groups over a mean follow-up of 52 (range: 24-120) months. The multivariable analysis showed that the expander-implant (odds ratio (OR) 2.15, p = 0.010) and the LD flap (OR 6.27, p < 0001) were significant risk factors for shoulder morbidity, compared to the DIEP flap. Old age (p = 0.041), presence of tumor-positive lymph nodes (p = 0.014), and receiving neoadjuvant chemotherapy (p = 0.002) were independent risk factors for the development of shoulder morbidity. Early rehabilitation within 2 postoperative-months reduced the risk of sustained shoulder morbidity.
DOI
10.1016/j.bjps.2018.07.033
Appears in Collections:
의과대학 > 의학과 > Journal papers
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