The Musculoskeletal Consequences of Breast Reconstruction using the Latissimus Dorsi Muscle:A Focus Group Study

Nicole Blackburn, Joseph G McVeigh, Eilis McCaughan, Iseult M. Wilson

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Background: Breast reconstruction using the latissimus dorsi (LD) flap following mastectomy is an important management option in breast cancer. However, one common, but often ignored, complication following LD flap reconstruction is shoulder dysfunction. The aim of the study, therefore, was to explore the musculoskeletal consequences of this surgery and their impact on function and quality of life as perceived by patients and the healthcare professionals who manage this client group.Materials and Methods: An integrated methodology was used in this study. Five focus groups were conducted; three with women who had undergone reconstructive surgery (n = 15) and two with the healthcare professionals (n = 11). The women also completed a demographics questionnaire, and their shoulder movement was assessed. All focus groups were audio and video recorded. Inductive content analysis was used to analyse transcripts and to develop core themes and sub-themes.Results: The over-arching theme to emerge from the women's focus groups was ‘Resilience’, sub-themes were ‘preparation and awareness’, ‘coping’ and ‘self-management’. Women reported a change in their musculoskeletal ability post-surgery but gradually returned to ‘new normal’ function, stating that they could now carry out their daily activities albeit for shorter periods of time, with assistance, or by adapting how they performed the task. The women recognised their lack of awareness regarding the potential long-term musculoskeletal implications of surgery, acknowledging pre and post-operative care to be mainly concerning wound healing and aesthetic outcome. This was reflected in the healthcare professionals group, whereby the breast care nurses demonstrated a varying awareness of the musculoskeletal impact of surgery, anticipating full recovery between three to twelve months. It was evident from the groups that the relative importance of overcoming the cancer and recovering from the adjuvant treatments was of higher priority than the potential of reduced function of the shoulder, following surgery.Conclusions: LD breast reconstruction has an impact on function and activities of daily living to varying extents, with women facing on-going challenges at least one year post-operative. As a result of the musculoskeletal implications of surgery women are adjusting to a ‘new normal’, demonstrating resilience in their approach to coping with this adaptive way of living. There is a lack of awareness regarding the long-term musculoskeletal consequences of surgery, with short-term follow up mainly regarding wound healing and aesthetic outcome, this has clinical implications for physiotherapists and breast care nurses in this area.
Original languageEnglish
Title of host publicationUnknown Host Publication
PublisherN/A
Number of pages1
Publication statusPublished - 9 Mar 2016
EventEuropean Breast Cancer Conference - Amsterdam, The Netherlands
Duration: 9 Mar 2016 → …

Conference

ConferenceEuropean Breast Cancer Conference
Period9/03/16 → …

Keywords

  • Survivorship
  • Quality of life
  • Function

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  • Research Output

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

    Blackburn, N., mcveigh, J., McCaughan, E., Kennedy, R., McIntosh, S. & Wilson, IM., 28 Aug 2018, In : PLoS ONE. 13, 8, 17 p., PONE-D-18-00316R3.

    Research output: Contribution to journalArticle

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