An innovative surgical breast reconstruction using tissue from her own womb of a woman to build a new breast after mastectomy could previously unrealized adverse side effects: muscle weakness.
The findings come from a new Canadian study published online Monday in Cancer, a peer-reviewed journal of the American Cancer Society.
`` Regardless of whether a patient had complications after surgery or not. . . seen that globally, the abdomen was the one who really took a big hit,''said lead study author Dr. Toni Zhong from the University Health Network, University of Toronto Breast rehabilitation program.
Until now, the surgeons believed that the advanced microsurgery aimed at preserving the nerves and muscles decreases the likelihood that women will experience loss of abdominal muscle. Noting that it is not always the case, Zhong said the study may help patients with breast cancer and the best surgeons decide which option is best for the patient.
The researchers interviewed 51 women between June 2009 and November 2010 undergoing breast reconstruction at the University of Toronto.
They looked only at women undergoing reconstruction using skin, fat and blood vessels - not muscles - the abdominal area to build a new breast, called a blow Diep or muscle-sparing TRAM flap.
`` We wanted to look specifically at the flap Diep. . . It is an extremely popular choice among women, and there is a very public interest in it from our patients,''said Zhong.
In the study, the first of its kind to examine the quality of life of patients with breast cancer and the level of satisfaction with the new breast after breast muscle sparing reconstructive surgery, patients were asked about their psychological, sexual and physical well-being and their level of depression or anxiety.
The women answered questions before the surgery, three weeks after surgery, and three months after surgery.
The results showed that after three weeks after surgery, women were significantly more satisfied with their new breasts and showed improved quality of life. Even in the 11 patients who developed complications after surgery, their satisfaction with the reconstruction of the breast is still high, the authors reported.
But Zhong said he was surprised to find that even during the most careful attempts to remove tissue without disturbing muscles, patients sometimes experienced muscle weakness or swelling that continues even three months after surgery.
`` It's not the point that they are bedridden or unable to engage in everyday activities, but can feel a little weak and does not have the power they used to have,''said Zhong. `` Some people are happy to tolerate this and say it is the price we paid to have such a big breast reconstruction. ''
However, for active patients who perceive a loss of muscle strength may be a problem, he said.
From her experience, said Zhong many patients regain strength in the abdomen through the treatment, but a swelling may require more surgery to tighten the muscles.
Zhong said the findings change the way you and other plastic surgeons will present reconstructive options for women in the future.
`` Before that, I think most plastic counsel women surgeons can expect reduced ventricular function for eight weeks, but after that you can get back to your normal life,''said Zhong. `` Now we are more careful when we counsel women to have this surgery.''
Results of this study removed by other findings that he saw a deterioration in quality of life, psychological and social well-being after breast reconstruction.
However, the authors said it is likely because other studies have examined all the different types of reconstruction, including the use of growth tissue and implants which is a two-stage surgery and needs more time to see the final results.
Zhong said he is working on an update to the study examines ventricular function in the same patients after six months to one year after surgery.
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