Factors affecting upper limb functional recovery after mastectomy with immediate breast reconstruction: a prospective study

ABSTRACT

Background

Little is known about the differences in postoperative shoulder function following two common approaches for immediate breast reconstruction (IBR): abdominal-based breast reconstruction and implant-based breast reconstruction (ABR and IMBR). It was hypothesized that postoperative upper limb function would differ between the ABR and IMBR due to incomplete detachment of the pectoral muscles.

Purpose

This study aimed to investigate the factors for shoulder function recovery post-IBR and compare recovery outcomes between ABR and IMBR.

Methods

This single-center prospective follow-up study included 60 patients who underwent IBR for 4 months postoperatively. Patients were invited to complete functional measurements 1 and 4 months postoperatively. The primary outcome was improvement in upper limb disability based on the Q-DASH score. Secondary outcomes were functional shoulder recovery markers: shoulder flexibility, strength, movement accuracy, scapular alignment, body schema accuracy, and neuropathic pain. Repeated-measures analyzes of variance and linear regression were performed.

Results

Within-group differences were found for most variables (p < .05) except for neuropathic pain (p = .929). However, there was no overall main group effect (p > .05). Multivariate regression analysis established significant models for ABR and IMBR (R² = 0.430, p = .002 and R² = 0.442, p < .001, respectively). However, the variables included in the model showed between-group differences.

Conclusion

Postoperative shoulder function was comparable between the two IBR approaches. However, different factors were associated with improved upper limb disability between ABR and IMBR. Acute rehabilitation focused on resolving muscle tightness and pain may help mitigate upper limb disabilities following IBR.

Trial registration number: KCT 0006501

KEYWORDS:

• Immediate breast reconstruction
• mastectomy
• rehabilitation
• upper limb disability

Acknowledgments

The devotion that all the participants provided to us was unforgettable. We would also like to thank Editage for English language editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary material.

Supplementary Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09593985.2024.2343043.

Additional information

Funding

The authors did not receive support from any organization for the submitted work.