Changes in shoulder muscle activity pattern on surface electromyography after breast cancer surgery
1Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Journal of Surgical Oncology
|August 24, 2017
Summary
Breast cancer surgery type impacts shoulder muscle activity and upper limb function. Transverse rectus abdominis flap (TRAM) reconstruction may best preserve function after axillary lymph node dissection (ALND).
Area of Science:
- Orthopedics
- Oncology
- Rehabilitation Medicine
Background:
- Breast cancer treatments, including surgery, often lead to altered muscle activation and reduced shoulder mobility.
- These changes can significantly impair upper limb function in patients.
Purpose of the Study:
- To investigate muscle activity patterns in breast cancer patients post-surgery.
- To compare the incidence of abnormal muscle activation patterns across different types of breast surgery and reconstruction methods.
Main Methods:
- Surface electromyography (sEMG) was used to measure shoulder muscle activity in 274 breast cancer patients.
- Patients were categorized by surgical approach: mastectomy without reconstruction, tissue expander/implant (TEI), latissimus dorsi (LD) flap, or transverse rectus abdominis flap (TRAM).
- Gaussian filter smoothing and regression analysis were employed for data analysis.
Main Results:
- Distinct muscle activation patterns (normal, reduced activity, tightness) were observed.
- Transverse rectus abdominis flap (TRAM) reconstruction was associated with significantly lower odds (40.2% less) of reduced muscle activity and (38.4% less) tightness compared to mastectomy alone, after adjusting for BMI and surgical type.
- Abnormal muscle activation patterns were more prevalent after axillary lymph node dissection (ALND) compared to sentinel lymph node biopsy (SLNB), except in patients who underwent TRAM reconstruction.
Conclusions:
- Muscle activity alterations vary based on the type of breast surgery and reconstruction used.
- For breast cancer patients undergoing axillary lymph node dissection (ALND), transverse rectus abdominis flap (TRAM) reconstruction appears to be the optimal choice for preserving upper limb function.
