Eun Joo Yang1, YoungOk Kwon2. 1. Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. 2. Division of Business Administration, Sookmyung Women's University, Seoul, Korea.
Abstract
BACKGROUND AND OBJECTIVES: Alterations in muscle activation and restricted shoulder mobility, which are common in breast cancer patients, have been found to affect upper limb function. The purpose of this study was to determine muscle activity patterns, and to compare the prevalence of abnormal patterns among the type of breast surgery. METHODS: In total, 274 breast cancer patients were recruited after surgery. Type of breast surgery was divided into mastectomy without reconstruction (Mastectomy), reconstruction with tissue expander/implant (TEI), latissimus dorsi (LD) flap, or transverse rectus abdominis flap (TRAM). Activities of shoulder muscles were measured using surface electromyography. Experimental analysis was conducted using a Gaussian filter smoothing method with regression. RESULTS: Patients demonstrated different patterns of muscle activation, such as normal, lower muscle electrical activity, and tightness. After adjusting for BMI and breast surgery, the odds of lower muscle electrical activity and tightness in the TRAM are 40.2% and 38.4% less than in the Mastectomy only group. The prevalence of abnormal patterns was significantly greater in the ALND than SLNB in all except TRAM. CONCLUSIONS: Alterations in muscle activity patterns differed by breast surgery and reconstruction type. For breast cancer patients with ALND, TRAM may be the best choice for maintaining upper limb function.
BACKGROUND AND OBJECTIVES: Alterations in muscle activation and restricted shoulder mobility, which are common in breast cancerpatients, have been found to affect upper limb function. The purpose of this study was to determine muscle activity patterns, and to compare the prevalence of abnormal patterns among the type of breast surgery. METHODS: In total, 274 breast cancerpatients were recruited after surgery. Type of breast surgery was divided into mastectomy without reconstruction (Mastectomy), reconstruction with tissue expander/implant (TEI), latissimus dorsi (LD) flap, or transverse rectus abdominis flap (TRAM). Activities of shoulder muscles were measured using surface electromyography. Experimental analysis was conducted using a Gaussian filter smoothing method with regression. RESULTS:Patients demonstrated different patterns of muscle activation, such as normal, lower muscle electrical activity, and tightness. After adjusting for BMI and breast surgery, the odds of lower muscle electrical activity and tightness in the TRAM are 40.2% and 38.4% less than in the Mastectomy only group. The prevalence of abnormal patterns was significantly greater in the ALND than SLNB in all except TRAM. CONCLUSIONS: Alterations in muscle activity patterns differed by breast surgery and reconstruction type. For breast cancerpatients with ALND, TRAM may be the best choice for maintaining upper limb function.
Authors: Nur Amalina Che Bakri; Richard M Kwasnicki; Kieran Dhillon; Naairah Khan; Omar Ghandour; Alexander Cairns; Ara Darzi; Daniel R Leff Journal: Ann Surg Oncol Date: 2021-07-26 Impact factor: 5.344