{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:13:41Z","timestamp":1787008421383,"version":"build-2736575974"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients undergoing postoncologic breast reconstruction can experience upper extremity (UE) functional deficits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In this study, we utilized the disabilities of the arm, shoulder, and hand (DASH) questionnaire to identify patient factors that impacted UE functional recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent oncologic followed by reconstructive surgery by a single surgeon from 2014 to 2019 and completed the DASH survey were included. A DASH score was calculated for each patient, with values ranging from 0 (no impairment) to 100 (severe impairment). Regression analysis was conducted to identify significant predictors for DASH score with a significance level for entry and stay set at P = .15.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 289 patients who underwent breast reconstruction, 157 completed the questionnaire. The average patient age was 52.6yrs \u00b1 8.6 at the time of reconstruction. A total of 111 had implant-based reconstruction, 15 had autologous reconstruction, and 24 had a combination of both. Average DASH score was 7.7 (range 0.0-52.5), with 74.1% of patients having a score greater than 0. Regression analysis showed 5 variables associated with significantly higher DASH scores: age between 50 and 60 years (P = .13), history of radiation (P = .01), placement of a subpectoral implant (P = .06), postoperative complications (P = .10), and lymphedema (P &amp;lt; .01). Autologous breast reconstruction (P = .04) was associated with a significantly lower DASH score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implant-based reconstruction, radiation history, postoperative complications, and age at reconstruction were associated with increased UE functional impairment in patients who underwent breast reconstructive surgery. Identification of these factors can inform areas for potential practice changes and improve patient counseling regarding postoperative expectations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 3<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjad352","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T19:48:28Z","timestamp":1701114508000},"page":"396-403","source":"Crossref","is-referenced-by-count":5,"title":["Upper Extremity Functional Outcomes After Breast Cancer Treatment: An Analysis of DASH Score in Breast Reconstruction Patients"],"prefix":"10.1093","volume":"44","author":[{"given":"Pooja","family":"Humar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Moroni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Raghuram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Balogun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan-Mai","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"De La Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"2024031521032781400_sjad352-B1","author":"Society, A.C"},{"key":"2024031521032781400_sjad352-B2","doi-asserted-by":"publisher","first-page":"9","DOI":"10.2147\/BCTT.S29142","article-title":"Patients opting for breast reconstruction following mastectomy: an analysis of uptake rates and benefit","volume":"5","author":"Howard-McNatt","year":"2013","journal-title":"Breast Cancer (Dove Med Press)"},{"issue":"2","key":"2024031521032781400_sjad352-B3","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/01.grf.0000211913.24789.4b","article-title":"Breast reconstruction","volume":"49","author":"Piasecki","year":"2006","journal-title":"Clin Obstet Gynecol"},{"issue":"4","key":"2024031521032781400_sjad352-B4","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1097\/SAP.0000000000001312","article-title":"Breast reconstruction: a century of controversies and progress","volume":"80","author":"Homsy","year":"2018","journal-title":"Ann Plast Surg"},{"issue":"1","key":"2024031521032781400_sjad352-B5","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1111\/j.1365-2354.2009.01141.x","article-title":"Short- and long-term recovery of upper limb function after axillary lymph node dissection","volume":"20","author":"Devoogdt","year":"2011","journal-title":"Eur J Cancer Care (Engl)"},{"issue":"4","key":"2024031521032781400_sjad352-B6","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1002\/jso.10271","article-title":"Recovery of upper limb function after axillary dissection","volume":"83","author":"Gosselink","year":"2003","journal-title":"J Surg Oncol"},{"issue":"5","key":"2024031521032781400_sjad352-B7","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1016\/s0002-9610(01)00602-x","article-title":"Axillary web syndrome after axillary dissection","volume":"181","author":"Moskovitz","year":"2001","journal-title":"Am J Surg"},{"issue":"6","key":"2024031521032781400_sjad352-B8","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1111\/j.1742-1241.2006.01152.x","article-title":"Morbidity after breast cancer treatment and physiotherapeutic performance","volume":"61","author":"Gomide","year":"2007","journal-title":"Int J Clin Pract"},{"issue":"3","key":"2024031521032781400_sjad352-B9","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1097\/MRR.0000000000000288","article-title":"The effect of preoperative exercise on upper extremity recovery following breast cancer surgery: a systematic review","volume":"41","author":"Yang","year":"2018","journal-title":"Int J Rehabil Res"},{"issue":"7","key":"2024031521032781400_sjad352-B10","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1016\/j.clbc.2022.08.001","article-title":"The characteristics of pain tolerance in patients who underwent unilateral breast cancer surgery: the effect of handedness and surgical site to assess the potential musculoskeletal symptoms and function","volume":"22","author":"Tugral","year":"2022","journal-title":"Clin Breast Cancer"},{"issue":"2","key":"2024031521032781400_sjad352-B11","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/S0894-1130(01)80043-0","article-title":"Measuring the whole or the parts? 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