Summary
Background
The study aims to determine the impact of delayed breast reconstruction on women with
breast-cancer treatment-related lymphoedema after mastectomy.
Methods
Twenty women with breast-cancer treatment-related arm lymphoedema prospectively requesting
breast reconstruction were included between January 2002 and June 2009. Lymphoedema
volume was calculated for each 5-cm segment using the formula for a truncated cone.
Results
Three patients underwent transverse rectus abdominis myocutaneous flap reconstruction,
five received pedicled latissimus dorsi myocutaneous flaps associated with a breast
implant and 12 a breast implant (silicone) alone. Median lymphoedema duration at the
time of breast reconstruction was 21 (interquartile range (IQR): 17–34) months. Breast
reconstruction was done a median of 30 (IQR: 23–56) months after mastectomy. The median
lymphoedema volume at medians of 5 (244 ml, IQR: 159–435) and 22 months (235 ml, IQR:
146–361) of follow-up after reconstruction compared to that measured 6 months before
breast reconstruction of 378 ml (IQR: 261–459) were significantly lower (p < 0.02 for both). Specific lymphoedema treatment, unchanged during the study, included
manual lymph drainage for all women, elastic sleeves for 19 and low-stretch bandages
for 14.
Conclusion
Delayed breast reconstruction is feasible for women who have developed lymphoedema
after mastectomy for breast cancer. Further studies are needed to compare the different
breast-reconstruction techniques and to determine their ideal timing (immediate or
delayed).
Keywords
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Article info
Publication history
Published online: April 03, 2012
Accepted:
March 8,
2012
Received:
October 20,
2011
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
