The study aims to determine the impact of delayed breast reconstruction on women with breast-cancer treatment-related lymphoedema after mastectomy.
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.
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.
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).
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- American College of Surgeons Oncology Group. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011.J Clin Oncol. 2007; 25: 3657-3663
- Morbidity of sentinel lymph node biopsy (SLN) alone versus SLN and completion axillary lymph node dissection after breast cancer surgery: a prospective Swiss multicenter study on 659 patients.Ann Surg. 2007; 245: 452-461
- Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements.J Clin Oncol. 2008; 26: 5213-5219
- Psychiatric problems in the first year after mastectomy.Br Med J. 1978; 1: 963-965
- The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study.Plast Reconstr Surg. 2003; 111: 1060-1068
- Volume measurement in lymphedema treatment: examination of formulae.Eur J Cancer Care. 1995; 4: 11-16
- Why and how post-mastectomy edema should be quantified in patients with breast cancer.Breast Cancer Res Treat. 2002; 75: 87-89
- Objective improvement in upper limb lymphoedema following ipsilateral latissimus dorsi pedicled flap breast reconstruction – a case series and review of literature.J Plast Reconstr Aesthet Surg. 2011; 64: 680-684
- Breast reconstruction and lymphedema.Plast Reconstr Surg. 2010; 125: 19-23
- An investigation of lymphatic function following free-tissue transfer.Plast Reconstr Surg. 1997; 99: 730-741
- Return of lymphatic function after flap transfer for acute lymphedema.Ann Surg. 1999; 229: 421-427
- Tissue expander breast reconstruction is not associated with an increase risk of lymphedema.Ann Surg Oncol. 2010; 17: 2926-2932
Published online: April 03, 2012
Accepted: March 8, 2012
Received: October 20, 2011
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.