Purpose/Hypothesis: In 2005, 57,778 women underwent breast reconstructions, either transverse rectus abdominus musculocutaneous (TRAM) flap or deep inferior epigastric perforator (DIEP) flap. The purpose was to examine the effects of breast reconstruction on quality of life and abdominal strength and endurance. It is hypothesized that women who have undergone breast reconstruction will have lower abdominal strength and endurance compared to age-matched healthy women and this will consequently have a negative impact on quality of life. Number of Subjects: 41 subjects (20 TRAM, 1 DIEP, 20 controls) volunteered to participate in this study. Women were recruited from local breast cancer support groups. On average, ~7 years had elapsed since reconstructive surgery and ~5 months elapsed between the mastectomy and reconstructive surgeries. Materials/Methods: This cross sectional study involved one testing session for abdominal strength, endurance and quality of life. Abdominal strength was measured by a hand held dynamometer and abdominal endurance was measured by the Dynamic Abdominal Endurance Test. Quality of life was assessed by self-reported measures including the RAND 36-Item Health Survey and a Reconstructive Questionnaire developed by the investigators. Results: The mean age of the breast reconstruction group was 57.4 yrs and the mean age of the controls was 51.6 yrs. The breast reconstruction group had significantly lower (p = 0.018) abdominal strength than the control group (31.6 +/- 8.24 lbs vs. 38.9 +/- 9.9 lbs respectively). Abdominal endurance was significantly lower (p = 0.01) in the breast reconstruction group (20 +/- 10 reps) as compared to the control group (32 +/- 13 reps). Participants in the breast reconstruction group who reported that they received physical therapy had a significantly greater abdominal strength (p = 0.019) than those who did not report receiving physical therapy (37.3 +/- 8.7 lbs. vs. 28.5 +/- 6.4 lbs, respectively). No significant correlations were found between strength or endurance and the physical function domains on the RAND survey. Conclusions: Women who have undergone breast reconstruction have lower abdominal strength and endurance when compared to age-matched healthy women. Women who underwent breast reconstruction and reported that they received physical therapy had significantly greater strength as compared to those who had surgery but not physical therapy. The RAND Survey may not be sensitive to changes in physical function that result from breast reconstruction as evidenced by subjects comments on the Reconstructive Questionnaire regarding their difficulty in performing some functional activities. Clinical Relevance: Physical Therapists should be aware of the strength and endurance deficits experienced by patients with breast reconstructions and further research is needed to examine the effect of these deficits on physical function and quality of life.