000			03121nam a22003617a 4500
008			181102s20192019 xxu||||| |||| 00| 0 eng d
022			_a0167-6806
024			_a10.1007/s10549-018-5003-8 [doi]
024			_a10.1007/s10549-018-5003-8 [pii]
040			_aOvid MEDLINE(R)
099			_a30328049
245			_aThe influence of reconstruction choice and inclusion of radiation therapy on functional shoulder biomechanics in women undergoing mastectomy for breast cancer.
251			_aBreast Cancer Research & Treatment. 173(2):447-453, 2019 Jan.
252			_aBreast Cancer Res Treat. 173(2):447-453, 2019 Jan
253			_aBreast cancer research and treatment
260			_c2019
260			_fFY2019
265			_saheadofprint
265			_sppublish
266			_d2018-11-02
501			_aAvailable online from MWHC library: 1997 - present
520			_aCONCLUSIONS: Disinsertion of the LD, not the disinsertion of the PM or radiotherapy, contributes to strength deficits following LD flap breast reconstructions. The combined disinsertion of the PM and LD compromises shoulder stability in the vertical plane. Shoulder function should be a focal point of the surgical decision-making process and postsurgical care.
520			_aMETHODS: Shoulder strength and stiffness were collected from 10 irradiated LD flap breast reconstruction patients, 14 two-stage subpectoral implant reconstruction patients (subpectoral), and 10 irradiated deep inferior epigastric perforator (DIEP) flap patients an average of 659 days post-reconstruction. Univariate ANOVAs examined surgical group differences in strength and stiffness.
520			_aPURPOSE: The functional implications of reconstructing the breast mound with a latissimus dorsi (LD) flap or placing an implant under the pectoralis major (PM) muscle is complicated by potential comorbidities from disinserting these muscles and adjuvant radiotherapy. We utilized novel robot-assisted measures of shoulder stiffness and strength to dissociate how breast reconstruction choice and inclusion of radiation therapy impact shoulder morbidity in post-mastectomy reconstruction patients.
520			_aRESULTS: There were main effects of surgical group on vertical adduction, vertical abduction, and internal rotation strength. The LD flap group was significantly weaker than the subpectoral group in all measures and significantly weaker than the DIEP group during vertical adduction. There was also a main effect of surgical group on vertical adduction stiffness, where the LD group exhibited significantly reduced stiffness while producing vertical adduction torque. No significant differences between the subpectoral and DIEP groups existed for any measure of shoulder strength or stiffness.
546			_aEnglish
651			_aCurtis National Hand Center
657			_aJournal Article
700			_aGiladi, Aviram M
790			_aDiefenbach BJ, Giladi AM, Leonardis JM, Lipps DB, Lyons DA, Momoh AO, Olinger TA
856			_uhttps://dx.doi.org/10.1007/s10549-018-5003-8 _zhttps://dx.doi.org/10.1007/s10549-018-5003-8
942			_cART _dArticle
999			_c3820 _d3820