# Improving the assessment and diagnosis of shoulder morbidity following mastectomy with breast reconstruction

> **NIH NIH R03** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $148,926

## Abstract

Mastectomy rates in the U.S. are increasing, driven by more breast cancer patients opting for a mastectomy
with breast reconstruction. The cosmetic and psychosocial benefits to post-mastectomy breast reconstruction
may come at a significant functional cost given the invasiveness of these procedures to the musculoskeletal
system. It is critical that we understand the functional impact of different breast reconstruction approaches to
help us enhance the availability of reconstruction surgeries within minimal functional impact and to better
identify patients who will need therapeutic interventions as no standard of post-operative care currently exists.
Our long term goal is to alleviate functional deficits following breast reconstruction by improving existing
surgical approaches to lessen functional morbidity and enhancing the early detection of patients predisposed
to shoulder morbidity. The overall objectives of this proposal is to begin addressing our goal by using
ultrasound shear wave elastography (SWE) to identify reconstruction surgeries that significantly impact the
pectoralis major, and by determining if these SWE measures can predict post-operative functional deficits. Our
central hypothesis is that reconstructive procedures that require muscle disinsertion produce greater
mechanical deficits of the pectoralis major and poorer upper extremity functional outcomes. The rationale for
our proposed study is that it will allow us to identify the precursors of functional deficits in breast reconstruction
patients. We will test our hypothesis by pursing two specific aims: 1) Determine how variations in surgical
approaches to immediate or delayed breast reconstruction impact the mechanical integrity of the pectoralis
major; and 2) Identify how post-operative mechanical changes to the pectoralis major relate to upper extremity
functional status and quality of life. Under the first aim, breast cancer patients undergoing four different
approaches to breast reconstruction will have the stiffness of the pectoralis major muscle prospectively
evaluated with SWE. Under the second aim, these prospective evaluations of the pectoralis major will be
associated with performance-based measures of upper extremity functional status and validated patient
reported outcomes. The approach is innovative, in the applicant's opinion, because it presents a new and
substantive method for evaluating post-operative function in patients following breast reconstruction, and is an
important first step in validating this technology as a prognostic biomarker for future shoulder morbidity. The
proposed research is significant, because it is expected to have broad translational importance for the
prevention and treatment of shoulder morbidity in breast reconstruction patients. We expect these findings will
immediately impacting clinical practice, including the adoption of surgical approaches with significantly reduced
functional morbidity and bringing new focus to the for active su...

## Key facts

- **NIH application ID:** 9912793
- **Project number:** 5R03HD097704-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** David B Lipps
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $148,926
- **Award type:** 5
- **Project period:** 2019-04-10 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9912793

## Citation

> US National Institutes of Health, RePORTER application 9912793, Improving the assessment and diagnosis of shoulder morbidity following mastectomy with breast reconstruction (5R03HD097704-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9912793. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*