The Effect of Mini-Latissimus Dorsi Flap (MLDF) Reconstruction on Shoulder Function in Breast Cancer Patients

Duymaz, Tomris; İyigün, Zeynep Erdoğan; İlgün, Ahmet Serkan; Ordu, Çetın; Üçüncü, Muhammed Zübeyr; Alço, Gül; Ozturk, Alper; Elbüken, Filiz; Aktepe, Fatma; Özmen, Vahit

doi:10.5152/ejbh.2019.4727

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…This study result is in accordance with the study by Duymaz T et al, that stated the mean age of the patient who underwent mastectomy was between 47-48 years old. 9 The study by Ibraheem MH et 13 Based on the characteristics of the total seroma in this study, the mean total seroma of LABC patients who underwent MRM without LD flap was 694.45 milliliter, Bali, and is the Faculty of Medicine, Universitas Udayana Hospital. This study was conducted from November 2018 until January 2020 by the Department of Surgical Oncology Faculty of Medicine, Universitas Udayana, Bali, Indonesia.…”

Section: Discussionmentioning

confidence: 69%

The effect of Modified Radical Mastectomy (MRM) with and without latissimus dorsi flap on seroma of Locally Advanced Breast Cancer (LABC) in Sanglah Hospital

Pramana¹,

Widiana²,

Widiana³

2021

Intisari Sains Medis

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Background: Locally Advanced Breast Cancer (LABC) is defined as breast cancer spread locoregionally and without any signs of metastasis. Stage IIIA breast cancer is one type of LABC that can be removed surgically, and Modified Radical Mastectomy (MRM) remains the first surgical option. Seroma production is one of the most common complications post MRM, with the hypothesis stating that the Latissimus Dorsi (LD) flap technique is responsible for resulting in higher seroma output. This study aims to compare seroma production in LABC patients post MRM with and without LD flap. Methods: This prospective cohort study was conducted in Sanglah General Hospital, Denpasar, between November 2018 and January 2020. The study sample was divided into 2 groups: LABC patients post MRM with and without LD flap reconstruction. Seroma was measured in milliliters (ml) and collected from the first to fifth day post-operation. Data were analyzed using SPSS version 21 for Windows. Results: Forty LABC patients were enrolled in this study. The mean age for the group without latissimus dorsi flap was 48.45±7.01 years and 49.40±10.77 years for the group with latissimus dorsi flap. The mean seroma production in LABC patients who underwent MRM without and with LD flap reconstruction was 696.45±66.37 ml and 490.10±62.11 ml. There was a significant difference in the total of seroma between the treatment group without-LD flap and compared to with-LD flap reconstruction (p<0.001). Conclusion: Seroma production is significantly higher in LABC patients post MRM without LD flap reconstruction than LABC patients with LD flap.

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Section: Discussionmentioning

confidence: 69%

The effect of Modified Radical Mastectomy (MRM) with and without latissimus dorsi flap on seroma of Locally Advanced Breast Cancer (LABC) in Sanglah Hospital

Pramana¹,

Widiana²,

Widiana³

2021

Intisari Sains Medis

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“…They reported that impaired shoulder function also led to a poorer quality of daily life in patients 6–12 months after surgery. Another study analyzing 174 patients using the Q-DASH scores showed that LDMF has a negative impact on shoulder function [ 12 ]. Although Zhou et al [ 13 ] showed no significant differences in muscle strength, shoulder range of motion, disabilities of the arm, shoulder, and hand scores between the LDMF and conventional BCS groups, the varied results may be due to the small number of patients analyzed in this study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Quality of Life and Cosmetic Outcome of Latissimus Dorsi Mini-Flap With Breast Conservation Surgery Without Reconstruction

et al. 2023

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Purpose Latissimus dorsi mini-flap (LDMF) reconstruction after breast-conserving surgery (BCS) is a useful volume replacement technique when a large tumor is located in the upper or outer portion of the breast. However, few studies have reported the impact of LDMF on patients’ quality of life (QoL) and cosmesis compared with conventional BCS. Methods We identified patients who underwent BCS with or without LDMF between 2010 and 2020 at a single center. At least 1 year after surgery, we prospectively administered the BREAST-Q to assess QoL and obtained the patients’ breast photographs. The cosmetic outcome was assessed using four panels composed of physicians and the BCCT.core software. Results A total of 120 patients were enrolled, of whom 62 and 58 underwent LDMF or BCS only, respectively. The LDMF group had significantly larger tumors, shorter nipple-to-tumor distances in preoperative examinations, and larger resected breast volumes than did the BCS-only group ( p < 0.001). The questionnaires revealed that QoL was poorer in the LDMF group, particularly in terms of the physical well-being score (40.9 vs. 20.1, p < 0.001). Notably, the level of patients’ cosmetic satisfaction with their breasts was comparable, and the cosmetic evaluation was assessed by panels and the BCCT.core software showed no differences between the groups. Conclusion Our results showed that cosmetic outcomes of performing LDMF are comparable to those of BCS alone while having the advantage of resecting larger volumes of breast tissue. Therefore, for those who strongly wish to preserve the cosmesis of their breasts, LDMF can be considered a favorable surgical option after the patient is oriented toward the potential for physical dysfunction after surgery.

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“…Another cross-sectional study including 174 patients divided into four groups with difference in axillary surgery [ALND vs. sentinel node (SN)] as well as in breast surgery (BCS vs. LD mini-flap reconstruction) found a negative impact on shoulder function for the group treated by the combination of ALND and LD mini-flap ( 43 ). This may speak to the favour of conventional BCS over LD mini-flap OPS in combination with ALND.…”

Section: Key Contents and Findingsmentioning

confidence: 99%

Shoulder function following oncoplastic breast conserving surgery—a narrative review

Lautrup,

Rindom,

Hauerslev

2024

Gland Surg

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Background and Objective The high prevalence of breast cancer survivors makes it very relevant to investigate late morbidity following the treatment. Oncoplastic breast conserving surgery (OPS) has gained great popularity over the past years, and evidence-based knowledge suggest better prognosis for treatment with breast conserving surgery (BCS) compared to mastectomy. The aim was to investigate if OPS causes late effects on an acceptable level compared to what we know about breast surgery causing late effects. Methods Using the Medical Subject Headings (MeSH) terms “Breast Neoplasms”, “shoulder”, “oncoplast*”, and “reconstruct*”, the databases PubMed, Embase, and Scopus were searched on the 6 th of June 2023. The literature search was managed in Covidence. We focused on studies describing late effects especially shoulder function including restrictions in mobility, reduced strength, as well as functional impairment. Key Content and Findings Nine studies fulfilled the inclusion criteria. Different kinds of oncoplastic procedures were described—most of them described volume replacement procedures. The knowledge of shoulder morbidity following OPS is limited. The heterogeneity in the selected studies was broad. Some of the studies were small and there was a considerable variation in follow-up time. They described shoulder function based on several different evaluation methods [range of motion (ROM), Disabilities of the Arm, Shoulder, and Hand (DASH), Quick-DASH (Q-DASH), Shoulder Pain and Disability Index (SPADI), health-related quality of life (HRQoL), and non-validated subjective questionnaires]. All studies found acceptable levels of shoulder morbidity. Conclusions The requisite knowledge of late effects following OPS is still not available for unambiguous recommendations. This narrative review has elucidated the knowledge and has reached a conclusion based on review of the existing literature of this item. We found that the risk of decreased shoulder function caused by OPS—volume displacement as well as volume replacement—does not exceed the risk of shoulder problems seen after BCS and mastectomy with or without immediate reconstruction. Therefore, OPS can be considered if conventional BCS is not possible. But the knowledge of shoulder function after OPS is limited, and studies comparing shoulder function after OPS, BCS and mastectomy with or without immediate reconstruction are warranted.

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The Effect of Mini-Latissimus Dorsi Flap (MLDF) Reconstruction on Shoulder Function in Breast Cancer Patients

Cited by 4 publications

References 32 publications

The effect of Modified Radical Mastectomy (MRM) with and without latissimus dorsi flap on seroma of Locally Advanced Breast Cancer (LABC) in Sanglah Hospital

The effect of Modified Radical Mastectomy (MRM) with and without latissimus dorsi flap on seroma of Locally Advanced Breast Cancer (LABC) in Sanglah Hospital

Comparison of Quality of Life and Cosmetic Outcome of Latissimus Dorsi Mini-Flap With Breast Conservation Surgery Without Reconstruction

Shoulder function following oncoplastic breast conserving surgery—a narrative review

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