The Impact of Surgical Breast Reduction on the Postural Control of Women with Breast Hypertrophy

Barbosa, Alessandra Ferreira; Lavoura, Patricia; Boffino, Catarina Costa; Siqueira, Cassio Marinho; Costa, Márcio Paulino; Junior, Jonas Eraldo de Lima; Tanaka, Clarice

doi:10.1007/s00266-012-0049-1

Cited by 14 publications

(16 citation statements)

References 21 publications

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“…Symmetry, natural shape, and proper size are biologically and esthetically important. An extremely large breast size may lead to difficulties in daily life and studies have demonstrated that physical weight and psychological factors may cause an altered skeletal posture (1)(2)(3). Moreover, many studies have reported that having both breasts is important in maintaining a center of gravity and stable posture (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Alteration in skeletal posture between breast reconstruction with latissimus dorsi flap and mastectomy: a prospective comparison study

Lee¹,

Park²,

Lee³

et al. 2021

Gland Surg

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Background: The latissimus dorsi (LD) flap is used in cases of immediate breast reconstruction after total or partial mastectomy. However, studies on the effect of unilateral LD flap reconstruction on skeletal posture and comparison with results from mastectomy-only have been sparse. Thus in this prospective, observational study, we compared skeletal posture and functional recovery in patients who underwent a mastectomy-only versus those who underwent breast reconstruction with a LD flap after mastectomy.Methods: From January 2018 to February 2020, a total of 54 patients were enrolled. The control group included 23 patients who underwent mastectomy-only and the experimental group included 31 patients who underwent breast reconstruction using a LD flap immediately after mastectomy. We assessed the Cobb's angle in spine X-rays, parameters derived from photometry, computed tomography (CT), and 3D scanning preoperatively (T0), 6 months post-surgery (T1), and 1-year post-surgery (T2). We also evaluated functional outcomes, such as pain intensity, disability of the upper extremities, and quality of life.Results: In the control and experimental groups, the average age was 58.7/46.2 years, body mass index (BMI) was 24.9/22.5, and excised mass weight was 386.8/259.1 g, respectively. In the control group, differences in the Cobb's angle were significant between T0 and T2 (P=0.003). There were significant differences in the Cobb's angle and time interaction effects between the two groups (P=0.015). The degree of change in the Cobb's angle between T0 and T1 was positively correlated with change in the vertical distance from the 3D scanner midline to the nipple (P=0.009). Conclusions:The experimental group showed improved recovery in skeletal posture compared to the control group. Further, discovering the parameters that can predict the change of skeletal posture through a 3D scanner will have clinical significance. Accordingly, performing breast reconstruction by unilaterally applying the LD muscle is a safe, reliable, and useful method of autologous tissue transfer for breast cancer patients.

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Section: Introductionmentioning

confidence: 99%

Alteration in skeletal posture between breast reconstruction with latissimus dorsi flap and mastectomy: a prospective comparison study

Lee¹,

Park²,

Lee³

et al. 2021

Gland Surg

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“…Sahin et al 19 used 3D gait analysis on 10 patients to demonstrate a statistically significant improvement in maximum anterior pelvic tilt (41% reduction), average maximum spine anterior flexion (30% improvement), and an improved body posture when walking after breast reduction surgery. In the study by Barbosa et al, 23 it was demonstrated that postoperative patients had a smaller center-of-displacement area and improved postural control. Tenna et al 24 demonstrated, by means of static stabilometry, that postoperative reduction mammaplasty patients have objectively improved posture at the 6-month postoperative mark ( P = 0.032).…”

Section: Resultsmentioning

confidence: 96%

“…In all studies that applied a component of pain evaluation, a significant improvement in pain postoperatively was demonstrated. 17,20,23,25,26…”

Section: Discussionmentioning

confidence: 99%

“…Nine studies evaluated a cohort of breast hypertrophy patients both preoperatively and postoperatively. [17][18][19][20][21][22][23][24][25] The studies by Sahin et al, 19 Lapid et al, 20 Barbosa et al, 23 Tenna et al, 24 Foreman et al, 25 and Krapohl 1 were nonradiological and more external measurement based. These 6 studies used 3D gait analysis, back inclination angle, center-of-pressure displacement, center-of-gravity oscillations, lower back compressive force, and functional spine score, respectively.…”

Section: Reviewed Studies Characteristicsmentioning

confidence: 99%

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The Effects of Breast Reduction on Back Pain and Spine Measurements: A Systematic Review

Papanastasiou

Ouellet

Lessard

2019

Plastic and Reconstructive Surgery - Global Open

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Background:The aim of this review article was to synthesize the literature on reduction mammaplasty and its effects on the spine. The particular focus was to find these few radiological studies and those investigating changes in spinal angles, posture, center of gravity, and back pain reduction.Methods:We performed a thorough review of the literature, searching the Medline database for all relevant published data studying reduction mammaplasty and the spine. The search yielded 107 articles of which 11 articles met our specific inclusion criteria. The primary outcome measures of the studies and their respective results were tabulated, contrasted, and compared.Results:The 11 cohort studies included in this review cover the period from 2005 to 2015 and focus on breast hypertrophy and spine. According to these 11 quantitative studies, breast hypertrophy causes objective, quantitative, measurable disturbances to women living with this condition. Reduction mammaplasty produces an unmistakable improvement in signs, symptoms, and quantifiable measures. Although the majority of included articles in this review described postoperative improvement in spinal angles, there remain discrepancies of results between them.Conclusions:The studies included in this review did offer a promising glimpse into the complex interaction between breast hypertrophy and the spine. However, future research initiatives can improve upon what these investigators have begun with more refined, objective, radiological evidence. More specifically, we aim to clarify some of the basic hypotheses in our center with the use of EOS.

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“…Thus, could be inferred that breast size influences the postural biomechanics. When assessing static balance in women with breast reduction, there is a decline in both, area and velocity displacement [21]. Barbosa et al [22] showed an increase in the area and velocity displacement of the pressure center of women with breast hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

Changes in Postural Control in Mastectomized Women

Montezuma¹,

Guirro²,

Vaz³

et al. 2014

JCT

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Background: Women undergoing mastectomy may have postural asymmetries due to mutilation, culminating in changes in postural balance. Aim: This study aimed to evaluate the influence of the mastectomy in the postural control of women undergoing surgical treatment of breast cancer. Methods: We evaluated 40 volunteers divided into two groups: women undergoing mastectomy (MG) with a mean age of 51.45 (SD 6.49) years old and mean BMI of 30.71 (SD 5.21) kg/m 2 , and a control group of women without the disease (CG) with a mean age of 50.50 (SD 7.85) years old and mean BMI of 30.50 (SD 5.77). Static balance was assessed using the displacement of the center of pressure (COP), with voluntary bipedal support with eyes open and closed on a force platform. Statistical analysis was performed using the software SPSS 21.0 with a significance level of 5%. Results: The MG showed an increase in the displacement area along the x-axis (P = 0.003) and total displacement (P < 0.001) with eyes open (EO), and an increase in the x-axis (P = 0.002) and total displacement (P < 0.001) with eyes closed (EC). Velocity in the x-axis (P < 0.001), y-axis (P < 0.001) and total velocity (P < 0.001) was higher with EO than EC. A rise in velocity was also observed in the x-and y-axis, and in total velocity with EC, when compared with the CG (P < 0.001). Displacement was higher for all variables in both groups with EC (P < 0.001). Conclusions: Surgery for unilateral mastectomy may significantly alter postural control in women with breast cancer.

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The Impact of Surgical Breast Reduction on the Postural Control of Women with Breast Hypertrophy

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 14 publications

References 21 publications

Alteration in skeletal posture between breast reconstruction with latissimus dorsi flap and mastectomy: a prospective comparison study

Alteration in skeletal posture between breast reconstruction with latissimus dorsi flap and mastectomy: a prospective comparison study

The Effects of Breast Reduction on Back Pain and Spine Measurements: A Systematic Review

Changes in Postural Control in Mastectomized Women

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