Tomris Duymaz1, Zeynep Erdoğan İyigün2, Ahmet Serkan İlgün3, Çetin Ordu4, Muhammed Üçüncü5, Gül Alço6, Alper Öztürk7, Filiz Elbüken8, Fatma Aktepe9, Vahit Özmen10. 1. Department of Physiotherapy and Rehabilitation, İstanbul Bilgi University School of Health Sciences, İstanbul, Turkey. 2. Department of Physiotherapy and Rehabilitation, İstanbul Bilim University School of Medicine, İstanbul, Turkey. 3. Department of General Surgery, Taksim Training and Research Hospital, İstanbul, Turkey. 4. Department of Medical Oncology, İstanbul Bilim University School of Medicine, İstanbul, Turkey. 5. Centre of Breast Health, İstanbul Florence Nightingale Hospital, İstanbul, Turkey. 6. Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey. 7. Department of General Surgery, Biruni University School of Medicine, İstanbul, Turkey. 8. Departmment of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey. 9. Department of Pathology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey. 10. Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey.
Abstract
OBJECTIVE: The aim of this study is to investigate the effect of mini latissimus dorsi flap (MLDF) reconstruction on ipsilateral shoulder functions. MATERIALS AND METHODS: Those included in the study are the patients aged between 23 and 73, who were operated with the diagnosis of early breast cancer (cT1-3)N0). The first group includes the patients who had sentinel lymph node biopsy (SLNB) with partial mastectomy. The second group consists of the patients who had axillary lymph nodule dissection (ALND) with partial mastectomy. The third group includes the patients who had SLNB and MLDF with partial mastectomy. The fourth group includes the patients who had ALND and MLDF with partial mastectomy. Patients' Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score work model point were recorded. RESULTS: 174 patients were included in this study. According to Q-DASH score, no functional change was detected in 69.5% of the patients, whereas slight functional loss was identified in 23.6%, moderate functional loss in 5.7%, severe functional loss 1.1%. In the comparison of Q-DASH scores in surgery groups, while these four groups were being analyzed, a significant difference was determined (p=0.007). When dual analyses were made, it was also established that the difference resulted from the group to which ALND and MLDF were applied together. CONCLUSION: We conclude that MLDF application for reconstruction purposes after breast surgery has a negative impact on shoulder functions of the patients who had both of partial mastectomy and ALND.
OBJECTIVE: The aim of this study is to investigate the effect of mini latissimus dorsi flap (MLDF) reconstruction on ipsilateral shoulder functions. MATERIALS AND METHODS: Those included in the study are the patients aged between 23 and 73, who were operated with the diagnosis of early breast cancer (cT1-3)N0). The first group includes the patients who had sentinel lymph node biopsy (SLNB) with partial mastectomy. The second group consists of the patients who had axillary lymph nodule dissection (ALND) with partial mastectomy. The third group includes the patients who had SLNB and MLDF with partial mastectomy. The fourth group includes the patients who had ALND and MLDF with partial mastectomy. Patients' Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score work model point were recorded. RESULTS: 174 patients were included in this study. According to Q-DASH score, no functional change was detected in 69.5% of the patients, whereas slight functional loss was identified in 23.6%, moderate functional loss in 5.7%, severe functional loss 1.1%. In the comparison of Q-DASH scores in surgery groups, while these four groups were being analyzed, a significant difference was determined (p=0.007). When dual analyses were made, it was also established that the difference resulted from the group to which ALND and MLDF were applied together. CONCLUSION: We conclude that MLDF application for reconstruction purposes after breast surgery has a negative impact on shoulder functions of the patients who had both of partial mastectomy and ALND.
Entities:
Keywords:
Breast reconstruction; latissimus dorsi flap; shoulder functions
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