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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-Je; Lee, Kyeong-Tae; Mun, Goo-Hyun; Pyon, Jai-Kyong; Bang, Sa Ik
- Ewha Authors
- 우경제
- SCOPUS Author ID
- 우경제
- Issue Date
- 2018
- Journal Title
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
- ISSN
- 1748-6815
1878-0539
- Citation
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY vol. 71, no. 12, pp. 1761 - 1767
- Keywords
- Breast reconstruction; Shoulder morbidity; Expander-implant; Latissimus dorsi flap; Deep inferior epigastric artery perforator flap; Rehabilitation
- Publisher
- ELSEVIER SCI LTD
- Indexed
- SCIE; SCOPUS
- 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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