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Long-term prospective assessment of shoulder function after breast reconstruction involving a latissimus dorsi muscle flap transfer and postoperative radiotherapy

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Abstract

Background

Several investigators have evaluated the impaired function of the shoulder after removal of the latissimus dorsi muscle for breast reconstruction. However, a few investigators have studied whether including radiotherapy has a negative effect on functional recovery of the shoulder by a long-term follow-up after surgery. In this study, we compared objective measurements of shoulder function preoperatively and postoperatively for 3 years after latissimus dorsi muscle (LDM) flap transfer and postoperative radiotherapy (PRT).

Methods

Eighteen patients who underwent unilateral transfer of a pedicled LDM flap and PRT within 2 months of breast-conserving surgery were enrolled in this study. Range of motion (ROM) and muscle strength in exhaustive shoulder movements were measured before surgery, and at 3 and 6 months, and 1 and 3 years.

Results

The results of ROM measurements at 3months postsurgery showed significant decreases in both flexion and abduction by 7.1 and 9.2 % and at 3 years postsurgery by 4.7 and 5.7 %. The muscle strength measurements at 3 months postsurgery showed statistically significant decreases both in adduction and in the 2nd medial rotation by 30.7 and 25.9 % and at 3 years postsurgery by 36.4 and 20.4 %. A significant improvement in these impairments was not observed for 3 years after surgery compared with that at 3 months after surgery.

Conclusion

A combination of the LDM flap procedure and PRT could be associated with a higher incidence of tissue adhesions in both flexion and abduction and muscle deficit both in adduction and in the 2nd medial rotation.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan

    Yoshihiro Sowa & Toshiaki Numajiri

  2. Department of Orthopaedics, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan

    Toru Morihara & Rie Kushida

  3. Department of Rehabilitation, University Hospital, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan

    Toru Morihara & Rie Kushida

  4. Department of Endocrine and Breast Surgery, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan

    Koichi Sakaguchi & Tetsuya Taguchi

Authors
  1. Yoshihiro Sowa
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  2. Toru Morihara
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  3. Rie Kushida
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  4. Koichi Sakaguchi
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  5. Tetsuya Taguchi
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  6. Toshiaki Numajiri
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Corresponding author

Correspondence to Yoshihiro Sowa.

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Conflict of interest

The authors have declared that no competing interests exist.

Financial disclosure

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Ethics statement

This study was approved by the ethics committee of our hospital (Kyoto Prefectural University of Medicine).

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Sowa, Y., Morihara, T., Kushida, R. et al. Long-term prospective assessment of shoulder function after breast reconstruction involving a latissimus dorsi muscle flap transfer and postoperative radiotherapy. Breast Cancer 24, 362–368 (2017). https://doi.org/10.1007/s12282-016-0711-6

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  • DOI: https://doi.org/10.1007/s12282-016-0711-6

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