Quality of Life, Abdominal Muscle Strength and Endurance of Women Following Breast Reconstruction

Purpose: The optimal approach to the integration of postmastectomy reconstruction and radiation therapy is not well-established. This review will summarize current literature pertaining to the most common types of reconstruction in the setting of postmastectomy radiation therapy (PMRT). Data Sources: Literature from PubMed was reviewed from 2000 to 2016. Study Selection: Studies were selected with relevance to “postmastectomy breast reconstruction,” “breast reconstruction,” and “breast reconstructive methods and PMRT.” Surgical outcomes, patient satisfaction, and cost-effectiveness were examined. Data Extraction: Data from publications was extracted, summarized, and converted to a table. Results of Data Synthesis: Implant-based techniques are on the rise, in the setting of PMRT. Implant-based methods are more affordable in the short term and result in immediate breast-mound formation compared to autologous methods. When compared to implant-based reconstruction with PMRT, autologous reconstruction with PMRT results in better quality of life (QoL) and sensory recovery as well as fewer complications and failures. Among autologous flaps, deep inferior epigastric perforator flaps are considered superior to transverse rectus abdominal muscle (TRAM) pedicled flaps and may be more suitable for PMRT. Latissimus dorsi and muscle-sparing free TRAM flaps are also viable options. In delayed autologous, which may be advantageous for high-risk patients, the optimal timing to delay surgery after radiation therapy is unknown. Reconstruction with a 2-stage tissue expander-implant technique offers good to excellent cosmetic outcomes in the setting of PMRT, although there may be complications in this 2-stage process. Conclusion: Surgical, cosmetic, quality of life, and life expectancy must be taken into account when selecting the way to integrate breast reconstruction and PMRT.

Download Full-text

A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap

British Journal of Plastic Surgery ◽

10.1054/bjps.2000.3427 ◽

2000 ◽

Vol 53 (7) ◽

pp. 578-583 ◽

Cited By ~ 181

Author(s):

Catriona Marie Futter ◽

Martyn Hector Cochrane Webster ◽

Suzanne Hagen ◽

Sarah Louise Mitchell

Keyword(s):

Muscle Strength ◽

Breast Reconstruction ◽

Abdominal Muscle ◽

Diep Flap ◽

Retrospective Comparison ◽

Abdominal Muscle Strength

Download Full-text

Quality of Life and Patient Satisfaction after Breast Reconstruction: Free TRAM vs. Expansion/Implant

Journal of Reconstructive Microsurgery ◽

10.1055/s-2006-947945 ◽

2006 ◽

Vol 22 (03) ◽

Author(s):

Laszlo Kovacs ◽

Nikolaos Papadopulos ◽

Mrkus Kloeppel ◽

Katja Schwenzer ◽

H Seitz ◽

...

Keyword(s):

Quality Of Life ◽

Patient Satisfaction ◽

Breast Reconstruction

Download Full-text

Breast reconstruction after breast cancer surgery – persistent pain and quality of life 1–8 years after breast reconstruction

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0026 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Nina Honkanen ◽

Laura Mustonen ◽

Eija Kalso ◽

Tuomo Meretoja ◽

Hanna Harno

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Breast Reconstruction ◽

Perforator Flap ◽

Persistent Pain ◽

Rectus Abdominis ◽

Preoperative Pain ◽

Significant Difference

Abstract Objectives To assess the long-term outcome of breast reconstructions with special focus on chronic postsurgical pain (CPSP) in a larger cohort of breast cancer survivors. Methods A cross-sectional study on 121 women with mastectomy and breast reconstruction after mean 2 years 4 months follow up. The mean time from breast reconstruction to the follow-up visit was 4 years 2 months. We studied surveys on pain (Brief Pain Inventory, BPI and Douleur Neuropathique 4, DN4), quality of life (RAND-36 health survey), sleep (insomnia severity questionnaire, ISI), mood (Beck’s Depression Index, BDI; Hospital Anxiety and Depression Scale, HADS), and a detailed clinical sensory status. Patients were divided into three groups: abdominal flap (Deep inferior epigastric perforator flap, DIEP; Free transverse rectus abdominis flap, fTRAM, and Pedicled transverse rectus abdominis flap, pTRAM), dorsal flap (Latissimus dorsi flap, LD and Thoracodorsal artery perforator flap, TDAP), and other (Transverse myocutaneous gracilis flap, TMG; implant). Clinically meaningful pain was defined ≥ 4/10 on a numeric rating scale (NRS). We used patients’ pain drawings to localize the pain. We assessed preoperative pain NRS from previous data. Results 106 (87.6%) of the patients did not have clinically meaningful persistent pain. We found no statistically significant difference between different reconstruction types with regards to persistent pain (p=0.40), mood (BDI-II, p=0.41 and HADS A, p=0.54) or sleep (p=0.14), respectively. Preoperative pain prior to breast reconstruction surgery correlated strongly with moderate or severe CPSP. Conclusions Moderate to severe CPSP intensity was present in 14% of patients. We found no significant difference in the prevalence of pain across different reconstruction types. Preoperative pain associated significantly with postoperative persistent pain.

Download Full-text

The effectiveness of high-intensity laser therapy on pain, range of motion, functional capacity, quality of life, and muscle strength in subacromial impingement syndrome: a 3-month follow-up, double-blinded, randomized, placebo-controlled trial

Lasers in Medical Science ◽

10.1007/s10103-020-03224-7 ◽

2021 ◽

Author(s):

Muhammed Yılmaz ◽

Selma Eroglu ◽

Umit Dundar ◽

Hasan Toktas

Keyword(s):

Quality Of Life ◽

Muscle Strength ◽

Controlled Trial ◽

Subacromial Impingement Syndrome ◽

Subacromial Impingement ◽

High Intensity Laser ◽

Double Blinded ◽

Intensity Laser

Download Full-text

Increased modifiable cardiovascular risk factors in patients with Takayasu arteritis: a multicenter cross-sectional study

Advances in Rheumatology ◽

10.1186/s42358-020-00157-1 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Alexandre Moura dos Santos ◽

Rafael Giovani Misse ◽

Isabela Bruna Pires Borges ◽

Bruno Gualano ◽

Alexandre Wagner Silva de Souza ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Muscle Strength ◽

Aerobic Capacity ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Metabolic Equivalent ◽

Handgrip Test

Abstract Background Modifiable cardiovascular risk factors (MCRFs), such as those related to aerobic capacity, muscle strength, physical activity, and body composition, have been poorly studied in Takayasu arteritis (TAK). Therefore, the aim of the study was to investigate MCRFs and their relationships with disease status and comorbidities among patients with TAK. Methods A multicenter cross-sectional study was conducted between 2019 and 2020, in which 20 adult women with TAK were compared with 16 healthy controls matched by gender, age, and body mass index. The following parameters were analyzed: aerobic capacity by cardiopulmonary test; muscle function by timed-stands test, timed up-and-go test, and handgrip test; muscle strength by one-repetition maximum test and handgrip test; body composition by densitometry; physical activity and metabolic equivalent by IPAQ, quality of life by HAQ and SF-36; disease activity by ITAS2010 and NIH score; and presence of comorbidities. Results Patients with TAK had a mean age of 41.5 (38.0–46.3) years, disease duration of 16.0 (9.5–20.0) years, and a mean BMI of 27.7±4.5 kg/m2. Three out of the 20 patients with TAK had active disease. Regarding comorbidities, 16 patients had systemic arterial hypertension, 11 had dyslipidemia, and two had type 2 diabetes mellitus, while the control group had no comorbidities. TAK had a significant reduction in aerobic capacity (absolute and relative VO2 peak), muscle strength in the lower limbs, increased visceral adipose tissue, waist-to-hip ratio, reduced walking capacity, decreased weekly metabolic equivalent, and quality of life (P< 0.05) as compared to controls. However, there were no correlations between these MCRFs parameters and disease activity. Conclusions TAK show impairment in MCRFs; therefore, strategies able to improve MCRF should be considered in this disease.

Download Full-text