Meme Kanserli Hastalarda Unilateral Mastektomi Sonrası Vücut Postürünün Değerlendirilmesi: Retrospektif Tek Merkezli Çalışma

Öz

Amaç: Bu çalışmada, meme kanseri nedeniyle unilateral mastektomi uygulanan hastalarda ameliyat öncesi ve sonrası spinal dizilim değişikliklerinin Cobb açısı kullanılarak kantitatif olarak değerlendirilmesi ve cerrahinin uzun dönem postüral etkilerinin ortaya konması amaçlanmıştır.

Gereç ve Yöntem: Bu retrospektif, tek merkezli çalışmaya 2 Ocak 2020 ile 30 Eylül 2024 tarihleri arasında histopatolojik olarak doğrulanmış meme kanseri tanısıyla unilateral basit mastektomi veya modifiye radikal mastektomi uygulanan ve ameliyattan en az 12 ay sonra takibi olan 29 hasta dahil edildi. Ameliyat öncesi ve sonrası pozitron emisyon tomografisi-bilgisayarlı tomografi görüntülerinden Cobb açıları ölçüldü. Vertebral eğim yönü ve eğim tarafı (ipsilateral, kontralateral, nötral) mastektomi tarafına göre belirlendi. Postural değişiklik büyüklüğü, ameliyat sonrası ile ameliyat öncesi Cobb açıları arasındaki mutlak fark olarak hesaplandı.

Bulgular: Çalışma grubunun yaş ortalaması 53,55 ± 13,32 yıl, ortalama vücut kitle indeksi (VKİ) 29,33 ± 5,84 kg/m² idi. Ortalama preoperatif Cobb açısı 7,16 ± 7,05° ve postoperatif değer 9,03 ± 6,23° olarak saptandı. Preoperatif ve postoperatif Cobb açıları arasındaki fark istatistiksel olarak anlamlıydı (p = 0,001). Hastaların %62,1'inde kontralateral yönde postüral eğilme geliştiği belirlendi. Preoperatif dönemde 7 hastada (%24,1), postoperatif dönemde 10 hastada (%34,5) Cobb açısı ≥10° idi. VKİ, eğim tarafına göre karşılaştırıldığında anlamlı farklılık gözlendi (p = 0,016).

Sonuç: Unilateral mastektomi sonrası spinal dizilimde ölçülebilir postüral değişiklikler gelişmektedir ve bu değişiklikler sıklıkla kontralateral yöndedir. Bu bulgular, unilateral mastektomi sonrası uzun dönem takipte postüral değerlendirmenin ve gerektiğinde erken rehabilitasyon stratejilerinin planlanmasının önemini vurgulamaktadır.

Anahtar Kelimeler

• Mastektomi
• meme kanseri
• Cobb açısı
• postür
• spinal dizilim
• skolyoz

Destekleyen Kurum

Bu çalışma için herhangi bir finansal destek alınmamıştır.

Etik Beyan

Bu çalışma için etik onay, Ordu Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu’ndan (karar no: 135, tarih: 11 Ekim 2024) alınmıştır.

Teşekkür

Bu çalışma, Yasemin Dönmez Yurtsever’in “Meme Kanserli Hastalarda Tek Taraflı Mastektomi Sonrası Vücut Postürünün Değerlendirilmesi: Retrospektif Tek Merkezli Çalışma” başlıklı tıpta uzmanlık tezinden üretilmiştir.

Evaluation of Body Posture After Unilateral Mastectomy in Breast Cancer Patients: A Retrospective Single-Center Study

Öz

Objective: This study aimed to quantify the pre- and postoperative changes in spinal alignment in patients treated with unilateral mastectomy for breast cancer using the Cobb angle, and to evaluate the long-term postural effects of surgery.

Materials and Methods: This retrospective, single-center study included 29 patients who underwent unilateral simple mastectomy or modified radical mastectomy for histopathologically confirmed breast cancer between January 2, 2020, and September 30, 2024, with a minimum postoperative follow-up of 12 months. Cobb angles were measured from coronal vertebral sections on positron emission tomography-computed tomography scans obtained before and after surgery. Vertebral curvature direction and slope side (ipsilateral, contralateral, or neutral relative to the mastectomy side) were determined. The magnitude of postural change was calculated as the absolute difference between postoperative and preoperative Cobb angles.

Results: The mean age was 53.55 ± 13.32 years, and the mean BMI was 29.33 ± 5.84 kg/m². The mean preoperative Cobb angle was 7.16 ± 7.05°, increasing to 9.03 ± 6.23° postoperatively (z = 3.353, p = 0.001). Contralateral postural tilt developed in 62.1% of patients. Ten patients (34.5%) exceeded the ≥10° scoliosis threshold postoperatively, compared with seven (24.1%) preoperatively. BMI differed significantly according to slope side (p = 0.016).

Conclusion: Measurable postural changes in spinal alignment develop following unilateral mastectomy, predominantly in the contralateral direction. These findings suggest that postural assessment should be integrated into long-term postoperative follow-up, and early rehabilitation strategies should be considered when indicated.

Anahtar Kelimeler

• Mastectomy
• breast cancer
• Cobb angle
• posture
• spinal alignment
• scoliosis

Destekleyen Kurum

No financial support was received for this study.

Etik Beyan

Ethical approval for this study was obtained from the Clinical Research Ethics Committee of Ordu University Faculty of Medicine (decision number: 135, dated: October 11, 2024).

Teşekkür

This study was derived from the medical specialty thesis of Yasemin Dönmez Yurtsever, entitled "Evaluation of Body Posture After Unilateral Mastectomy in Patients with Breast Cancer: A Retrospective Single-Center Study."

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