Joon Seok Lee1, Eunhee Park2, Jung Ho Lee, Jeeyeon Lee3, Ho Yong Park3, Jung Dug Yang4, Tae-Du Jung5. 1. Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. 2. Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. 3. Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. 4. Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. lambyang@knu.ac.kr. 5. Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. teeed0522@knu.ac.kr.
Abstract
BACKGROUND: After skin-sparing mastectomy, direct-to-implant breast reconstruction is divided into a subpectoral and prepectoral techniques. However, there is still lack of studies that have compared the functional recovery after reconstruction based on the two techniques. Therefore, this study was conducted as a prospective comparison of the functional recovery and quality of life between the two techniques. METHODS: Patients who had undergone mastectomy for breast cancer were grouped based on whether the approach during direct-to-implant reconstruction was subpectoral or prepectoral. Functional outcomes were evaluated pre-operatively, 2 weeks, 1, 3, and 6 months post-operation. The evaluation included range of motion of the shoulder, maximal muscle power of the shoulder, pain intensity (measured by the visual analogue scale), disability of the upper extremity (measured by the Disabilities of the Arm, Shoulder and Hand questionnaire), quality of life (measured by the 36-Item Short-Form Health Survey), and mood status [measured by the hospital anxiety and depression scale (HADS)]. Repeated-measures analysis of variance was performed to evaluate changes in functional assessments. RESULTS: In the subpectoral/prepectoral groups, the average age, body mass index (BMI), preoperative breast volume, and implant volume were 45.5/45.1 years, 22.6/22.7 kg/m2 , 244.5/206.0 cm3 , and 258.6/ 234.8 cm3 , respectively. There were no significant differences in functional assessments between the two groups before the operation. There were significant differences in visual analogue scale, Disabilities of the Arm, Shoulder and Hand (DASH) scores, and time interaction effects between the two groups. In post-hoc analysis, the prepectoral group exhibited lower visual analogue scale and DASH scores than those in the subpectoral group at 2 weeks post-operation. CONCLUSIONS: The prepectoral group showed favorable recovery of pain intensity and disability of the upper arm at the early phase post-operation. Both groups functionally recovered at 6 months post-operation. Therefore, the prepectoral technique can be considered as a useful alternative technique, compared to the classic subpectoral technique.
BACKGROUND: After skin-sparing mastectomy, direct-to-implant breast reconstruction is divided into a subpectoral and prepectoral techniques. However, there is still lack of studies that have compared the functional recovery after reconstruction based on the two techniques. Therefore, this study was conducted as a prospective comparison of the functional recovery and quality of life between the two techniques. METHODS:Patients who had undergone mastectomy for breast cancer were grouped based on whether the approach during direct-to-implant reconstruction was subpectoral or prepectoral. Functional outcomes were evaluated pre-operatively, 2 weeks, 1, 3, and 6 months post-operation. The evaluation included range of motion of the shoulder, maximal muscle power of the shoulder, pain intensity (measured by the visual analogue scale), disability of the upper extremity (measured by the Disabilities of the Arm, Shoulder and Hand questionnaire), quality of life (measured by the 36-Item Short-Form Health Survey), and mood status [measured by the hospital anxiety and depression scale (HADS)]. Repeated-measures analysis of variance was performed to evaluate changes in functional assessments. RESULTS: In the subpectoral/prepectoral groups, the average age, body mass index (BMI), preoperative breast volume, and implant volume were 45.5/45.1 years, 22.6/22.7 kg/m2 , 244.5/206.0 cm3 , and 258.6/ 234.8 cm3 , respectively. There were no significant differences in functional assessments between the two groups before the operation. There were significant differences in visual analogue scale, Disabilities of the Arm, Shoulder and Hand (DASH) scores, and time interaction effects between the two groups. In post-hoc analysis, the prepectoral group exhibited lower visual analogue scale and DASH scores than those in the subpectoral group at 2 weeks post-operation. CONCLUSIONS: The prepectoral group showed favorable recovery of pain intensity and disability of the upper arm at the early phase post-operation. Both groups functionally recovered at 6 months post-operation. Therefore, the prepectoral technique can be considered as a useful alternative technique, compared to the classic subpectoral technique.
Entities:
Keywords:
early functional outcomes; Direct-to-implant breast reconstruction; pre-pectoral technique; sub-pectoral technique
Authors: Ian J Saldanha; Justin M Broyles; Gaelen P Adam; Wangnan Cao; Monika Reddy Bhuma; Shivani Mehta; Andrea L Pusic; Laura S Dominici; Ethan M Balk Journal: Plast Reconstr Surg Glob Open Date: 2022-03-18
Authors: Vladimir Mégevand; Matteo Scampa; Helen McEvoy; Daniel F Kalbermatten; Carlo M Oranges Journal: Cancers (Basel) Date: 2022-08-30 Impact factor: 6.575