Quality of life and shoulder function after latissimus dorsi breast reconstruction^☆

Breast reconstruction using a latissimus dorsi flap impacts one of the principal muscles of the shoulder. There is therefore concern that this procedure could impair shoulder function. The primary objective of this study was to study the effect of breast reconstruction using the latissimus dorsi flap on patient reported shoulder function and quality of life, compared to women who underwent total mastectomy without reconstruction.

A case-controlled cross-sectional study was conducted using the validated Breast-Q questionnaire and a functional back and shoulder questionnaire. Questionnaires were mailed to women who had undergone latissimus dorsi flap breast reconstruction (n = 100) and women who had undergone total mastectomy without reconstruction (n = 121). The responses from the 2 groups were compared, and results were analysed with t-test and Pearson's Correlation.

Responses were received from 119 patients (60 latissimus dorsi patients and 59 mastectomy alone patients). Latissimus dorsi flap patients had significantly higher Breast-Q scores for all quality of life domains when compared to mastectomy alone patients. There was, however, no significant difference in functional back and shoulder scores between the two groups. Latissimus dorsi flap patients also scored highly for satisfaction with outcome and satisfaction for the 'back'.

Patients report high levels of satisfaction following Latissimus dorsi flap breast reconstruction. This type of reconstruction did not adversely impact back and shoulder function.