Scapular dyskinesis after breast reconstruction surgery for breast cancer: a retrospective clinical analysis on 67 patients

Purpose: Mastectomy and breast reconstruction surgery are often associated with postoperative pain and functional limitation at the ipsilateral shoulder, potentially leading to scapular dyskinesis. However, few studies have determined how the type of surgery and rehabilitation might affect the development of such clinical condition. Methods: A retrospective observational study was performed on a clinical database of females who underwent surgical and adjuvant disease control treatment against breast cancer. Data included in this analysis were: demographics and clinical history, type of surgery and duration of physiotherapy, complications, as well as scapulohumeral rhythm and shoulder soreness evaluated during the orthopedic visit. Results: Based on the inclusion and exclusion criteria, 67 females (age 52 y, range 30-69) entered the statistical analysis. Static dyskinesis was present in 64.2% of the sample at the time of the visit, and it was found present bilaterally in 29.9% of the sample, whereas dynamic dyskinesis was found in 73.1% of the sample at the time of the visit. Longer physiotherapy (> 20 sessions) showed a trend for a lower risk of dynamic dyskinesis (OR 0.228, 95% CI 0.046-1.114, p = 0.072), and compared to the Subpectoral Tissue Expander, Prepectoral Implant-Based Breast Reconstruction presented a reduced risk for dynamic dyskinesis (OR 0.265, 95% CI: 0.074-0.952, p = 0.042). Conclusion: These preliminary findings suggest that some factors, such as the type of surgery and physiotherapy, might influence the development of scapular dyskinesis in females who undergo mastectomy and breast reconstruction.