The musculoskeletal consequences of latissmus dorsi breast reconstruction in women following mastectomy for breast cancer

dc.contributor.authorBlackburn, Nicole E.
dc.contributor.authorMc Veigh, Joseph G.
dc.contributor.authorMc Caughan, Eilis M.
dc.contributor.authorKennedy, Richard D.
dc.contributor.authorMcIntosh, Stuart A.
dc.contributor.authorWilson, Iseult M.
dc.contributor.funderDepartment of Employment and Learning, Northern Irelanden
dc.contributor.funderCancer Focus Northern Irelanden
dc.date.accessioned2019-10-28T07:55:09Z
dc.date.available2019-10-28T07:55:09Z
dc.date.issued2018-08-28
dc.description.abstractIntroduction: Current evidence suggests that patients who have latissimus dorsi (LD) breast reconstruction following mastectomy for breast cancer can experience long-term shoulder dysfunction. However, as there is no standardised assessment or follow-up period within the literature, findings are conflicting. This research aimed to investigate the impact on daily living of immediate and delayed LD breast reconstruction in women following mastectomy for breast cancer. Methods: Both qualitative and quantitative methods of enquiry were used. A focus group study explored the musculoskeletal consequences of surgery as perceived by the women (n = 15) and their healthcare professionals (n = 11). A questionnaire survey was administered (n = 159), including a range of outcome measures to quantify both the physical and psychosocial impact of LD breast reconstruction. Dyad interviews were also conducted in order to determine the impact of surgery on function and activities of daily living (ADL) from the woman’s perspective and that of her significant other (n = 8). Results: The qualitative studies highlighted a lack of preparedness and unrealistic expectations regarding functional recovery among women and their significant others’. Post-surgery it was apparent that women weighed up reduced shoulder function against survival, demonstrating resilience in their approach to coping with this adaptive way of living. The survey identified low to moderate effect on the outcomes assessed (n = 159), however, node removal significantly impacted certain aspects of quality of life (p<0.05) and disability (p = 0.04). Conclusions: Breast reconstruction using the LD had an impact on shoulder function and some ADL, which impacted not only on the women but also family and significant others. Despite the functional implications associated with surgery, findings would suggest that shoulder dysfunction is not their main concern. This work identified that women and their significant other require further information to clarify expectation regarding recovery, highlighting the changing priorities of women throughout their journey from diagnosis into long-term recovery.en
dc.description.sponsorshipDepartment of Employment and Learning, Northern Ireland (author's studentship)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide0202859en
dc.identifier.citationBlackburn, N.E., Mc Veigh, J.G., Mc Caughan, E.M., Kennedy, R.D., McIntosh, S.A. and Wilson, I.M., 2018. The musculoskeletal consequences of latissmus dorsi breast reconstruction in women following mastectomy for breast cancer. PloS one, 13(8), e0202859., (17 pp.). DOI:10.1371/journal.pone.0202859en
dc.identifier.doi10.1371/journal.pone.0202859en
dc.identifier.eissn1932-6203
dc.identifier.endpage17en
dc.identifier.issued8en
dc.identifier.journaltitlePLoS ONEen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8901
dc.identifier.volume13en
dc.language.isoenen
dc.publisherPLoSen
dc.relation.urihttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202859
dc.rights© 2018 Blackburn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are crediteden
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectBreast reconstructionen
dc.subjectMastectomyen
dc.subjectCancer treatmenten
dc.subjectCancer detectionen
dc.subjectFlap surgeryen
dc.titleThe musculoskeletal consequences of latissmus dorsi breast reconstruction in women following mastectomy for breast canceren
dc.typeArticle (peer-reviewed)en
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