Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies

Chadbourne, Elenie B.; Zhang, Shuhuan; Gordon, Matt; Ro, Eric Y.; Ross, Susan D.; Schnur, Paul; Schneider-Redden, Petra R.

doi:10.4065/76.5.503

Cited by 148 publications

(105 citation statements)

References 46 publications

(99 reference statements)

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“…Similar prospective studies were conducted by Blomqvist et al (11) and Behmand et al (12), but with short-term postoperative follow-up periods ranging from six to 12 months. Behmand et al's analysis of the study performed by Chadbourne et al (13) reported that reduction mammoplasty improved the physical and psychological symptoms associated with breast hypertrophy. Thoma et al (14) demonstrated that breast reduction results in the improvement of breast hypertrophy symptoms within a month following surgery.…”

Section: Discussionmentioning

confidence: 99%

Bilateral reduction mammoplasty following breast cancer: A case-control study

Cin¹,

Knight²,

Whelan³

2012

J Plastic Surgery

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S ymptoms of breast hypertrophy can affect post-treatment breast cancer patients. The true incidence of breast hypertrophy in the breast cancer population is unknown, as is the number of such patients seeking reduction mammoplasty surgery following breast cancer treatment. These patients have usually undergone lumpectomies followed by postoperative radiation therapy and chemotherapy. Although there can be changes in the shape and size of the treated breast as a result of lumpectomy and radiation, it is usually minimal in nature, resulting in, at most, asymmetry (1,2). In the macromastic patient, symptoms of interscapular back pain, prominent shoulder grooving, and intertrigo along the inframammary folds or between the breasts remain despite the described changes to the cancer-afflicted breast.Numerous publications regarding breast reconstruction following irradiation report that the radiated breast site is more prone to complications than the nonradiated breast (2-5). Currently, little information has been published regarding reduction mammoplasties performed on women previously treated for breast cancer. The radiated breast is expected to exhibit a likelihood of delayed wound healing, increased postoperative complications and less pleasing final results. In addition, it is unclear whether reduction mammoplasty in the radiated breast can be safely performed without interfering with mammography and cancer surveillance. We sought to review the outcomes of patients who underwent bilateral reduction mammoplasty following lumpectomy and radiation for breast cancer. The primary focus of the present study was the subsequent complications and need for additional surgery in this (particular?) patient population. MethodsAfter approval from the Hamilton Health Sciences Research Ethics Board, a retrospective search was conducted using the health records of Hamilton Health Sciences, McMaster University and the Juravinski Cancer Centre (Hamilton, Ontario) to identify patients who underwent lumpectomy and radiation (with or without chemotherapy) for breast cancer with subsequent bilateral reduction mammoplasty between 1980 and 2007. Patients who had undergone bilateral or unilateral reduction mammoplasty surgery before lumpectomy and radiation treatment, breast augmentation or lumpectomy alone were excluded from the study. PurPose: Many women undergo a bilateral reduction mammoplasty after lumpectomy and radiation for breast cancer due to breast hypertrophy. The outcomes of these patients, focusing on complications and the need for additional surgery, are reviewed. Methods: A matched case-control study with patients serving as their own control (treated breast cancer breasts were 'cases', healthy breasts were 'controls') was performed. Patients were identified through hospital records between 1980 and 2007. Patients treated by lumpectomy and radiation with subsequent bilateral reduction surgery were included. Data regarding demographics, medical history, and peri-and postoperative complications were collected. Measured outcome...

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Section: Discussionmentioning

confidence: 99%

Bilateral reduction mammoplasty following breast cancer: A case-control study

Cin¹,

Knight²,

Whelan³

2012

J Plastic Surgery

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“…shown to be inconsistent for comparisons (4,13,14) . The evaluation of spinal pain and restraints resulting from these symptoms in patients with breast hypertrophy, assessed from a patient's point of view, and using instruments of which measurement properties have already been tested, lends higher reliability to the study.…”

Section: Table 2 -Comparisons Of Groups Regarding Variables Of Pain Amentioning

confidence: 99%

Dores na coluna: avaliação em pacientes com hipertrofia mamária

et al. 2007

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OBJETIVO: Avaliar a influência da hipertrofia mamária sobre as dores na coluna e o quanto poderão comprometer as atividades habituais das pacientes. MÉTODOS: Realizou-se estudo transversal analítico em pacientes dos ambulatórios de Ortopedia e Cirurgia Plástica do Hospital Universitário Samuel Libânio, Pouso Alegre - MG. Foram examinadas 100 mulheres, 50 com hipertrofia mamária (grupo estudo) e 50 com mamas normais (grupo controle). O tamanho das mamas foi classificado conforme critérios de Sacchini.. A Escala Numeral Analógica (NRS) e o questionário de Roland-Morris foram utilizados para avaliar a intensidade das dores na coluna e as limitações resultantes destes sintomas. Realizado teste estatístico comparando os grupos em relação as variáveis analisadas. RESULTADOS: A média da idade das pacientes do grupo estudo e controle foram de 32,2 anos e de 32,7 anos respectivamente, e o IMC foi maior no grupo estudo. Os escores do NRS e do Roland-Morris foram maiores no grupo de estudo em relação ao grupo controle com significância estatística. CONCLUSÃO: Os resultados obtidos mostraram que as dores nas costas são mais intensas e determinaram maior limitação das atividades habituais em pacientes portadoras de hipertrofia mamária.

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“…Sintomas que vão desde síndrome do túnel do carpo até dor na coluna e diminuição da capacidade funcional apresentam melhora com a mamoplastia redutora (20,21) .…”

Section: Pacientes E Métodosunclassified

Influência da hipertrofia mamária na capacidade funcional das mulheres

Araújo¹,

Gomes²,

Veiga³

et al. 2007

Rev. Bras. Reumatol.

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IntRoduçãoO termo capacidade funcional tem sido usado como um dos parâmetros de avaliação de qualidade de vida relacionado à saúde. É interpretado como a capacidade de o paciente realizar atividades diárias comuns (1) . A hipertrofia mamária pode ser definida como "um aumento da glândula mamária além dos limites fisiológicos, com exceção dos aumentos causados por ferimentos, hemorragias, inflamações e gravidez" (2) . Estudos demonstraram o quanto a hipertrofia mamária pode alterar o componente funcional, acarretando transtornos de ordem circulatória, respiratória e postural. Influência da Hipertrofia Mamária na CapacidadeFuncional das Mulheres AbstRActObjective: to investigate the influence of breast hypertrophy in the musculoskeletal-system through the evaluation of the functional capacity in women. Method: 50 women with breast hypertrophy were studied and the results were compared to the 50 women without breast hypertrophy. The STANFORD HEALTH ASSESSMENT QUESTIONNAIRE 20 (HAQ-20) was applied to assess the functional capacity. It contains 20 questions about daily activities in which the patient has four answer options, which are scored. Lower scores indicate better functional capacity. Results: the mean score in the control group was 0.10, while in the breast hypertrophy group it was 0.71. When Mann-Whitney test was run, hypertrophy group showed statistically higher scores (p < 0.00). Conclusion: breast hypertrophy patients have more difficulties to perform common activities of the daily life.Keywords: breast, questionnaires, posture, hypertrophy, back pain. ResumoObjetivo: investigar a influência da hipertrofia mamária no sistema musculoesquelético por meio da avaliação da capacidade funcional das mulheres. Método: foram avaliadas 50 mulheres com hipertrofia mamária, e os resultados foram comparados com os de 50 mulheres com mamas normais. Para avaliação da capacidade funcional, utilizou-se o STANFORD HEALTH ASSESSMENT QUESTIONNAIRE 20 (HAQ-20), que consiste de 20 questões sobre atividades do cotidiano em que a entrevistada tem quatro opções de resposta, que são pontuadas. Quanto menor a pontuação, melhor a capacidade funcional. Resultados: a média dos escores do grupo-controle foi 0,10 e do grupo-hipertrofia foi igual a 0,71. Esses escores submetidos ao teste de Mann-Whitney mostraram que o grupo-hipertrofia apresentou valores significantemente maiores do que o grupo-controle (p < 0,00). Conclusão: mulheres com hipertrofia mamária apresentam menor capacidade funcional, ou seja, mais dificuldade para realizar atividades comuns da vida diária.Palavras-chave: mama, questionários, postura, hipertrofia, dor nas costas.Isso traz repercussão no centro de gravidade normal e exacerbação das curvaturas fisiológicas da coluna vertebral, ocasionando dor, alterações posturais da região deltóidea e dermatite submamária (3)(4)(5) . Por isso, alterações mamárias do tamanho têm sido tratadas como anomalias (4) .As dorsolombalgias têm alta prevalência e representam um desafio para a medicina em geral, sendo as mais freqüentes...

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Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies

Cited by 148 publications

References 46 publications

Bilateral reduction mammoplasty following breast cancer: A case-control study

Bilateral reduction mammoplasty following breast cancer: A case-control study

Dores na coluna: avaliação em pacientes com hipertrofia mamária

Influência da hipertrofia mamária na capacidade funcional das mulheres

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