The Influence of Functional Shoulder Biomechanics as a Mediator of Patient Reported Outcomes Following Mastectomy and Breast Reconstruction

Joshua M Leonardis, Daniel A Lyons, Kelley M Kidwell, Aviram M Giladi, David B Lipps, Adeyiza O Momoh

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Post-mastectomy breast reconstruction techniques differentially influence patient-reported physical and psychosocial well-being. Objective measures of shoulder biomechanics, which are uniquely influenced by reconstruction technique, may provide insight into the influence of reconstruction technique on patient-reported outcomes.

Robot-assisted measures of shoulder strength and stiffness, and patient-reported outcomes surveys (PROMIS-UE, SPADI, QuickDASH, SF12-PCS, SF12-MCS) were obtained from 46 women who had previously undergone mastectomy and a combined latissimus dorsi flap + subpectoral implant (LD + subpectoral implant), subpectoral implant, or DIEP flap breast reconstruction. Mediation analyses examined the role of functional shoulder biomechanics as a mediator between reconstruction technique and patient-reported outcomes.

In the current cohort, LD+subpectoral implant breast reconstructions significantly reduced shoulder strength and stiffness when compared to the other techniques. Additionally, objective measures of shoulder biomechanics were predictive of patient-reported physical and psychosocial well-being. Our results emphasize the need for improved peri-operative screening for shoulder functional deficits in patients undergoing breast reconstruction.

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Jasmine Walter

Content Editor, Mark Allen Group

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