The extent and impact of musculoskeletal dysfunction on women following breast reconstruction using the Latissimus Dorsi muscle. A questionnaire survey

Background
Quality of life is becoming more important in regard to Breast Cancer as treatment advances extend the period of survivorship. Breast reconstruction following mastectomy is an important management option in breast cancer, therefore the functional implications associated with this surgery must be considered. To date, literature has mainly focused on body image and wound healing with little in-depth investigation of the impact of the surgery on shoulder function. Few studies have specifically investigated the musculoskeletal impact of surgery and of those that have, findings have varied regarding the impact and extent.
Method
A postal survey design was used to gather detailed and personal information from women who had latissimus dorsi (LD) breast reconstruction. All eligible women who underwent LD flap surgery through the Northern Ireland Health and Social Care Trusts were included in the study. A range of validated outcome measures were included in order to determine both the physical and psychosocial implications of LD breast reconstruction in women following mastectomy for breast cancer.

Results
A total of 159 women, (mean age = 46.8 ± 7.9 years; mean time since surgery = 4.3 ± 2.9 years) completed the survey. The results from the validated outcome measure scores demonstrated low to moderate dysfunction among the group. Subgroup analysis revealed that auxiliary node removal significantly impacted disability scores (p=.036) as per DASH and quality of life scores regarding mobility (p=.008) and self-care (p=.030) as per EuroQol.
Conclusion
The findings from this study indicate that LD breast reconstruction has an impact on the functional ability of patients undergoing this specific procedure, with the results from the validated outcome measure scores demonstrating low to moderate dysfunction among the group.