Positive impact of delayed breast reconstruction on breast-cancer treatment-related arm lymphoedema
Identifieur interne : 004953 ( Main/Merge ); précédent : 004952; suivant : 004954Positive impact of delayed breast reconstruction on breast-cancer treatment-related arm lymphoedema
Auteurs : Marie Blanchard [France] ; Maria Arrault [France] ; Stephane Vignes [France]Source :
- Journal of plastic, reconstructive & aesthetic surgery [ 1748-6815 ] ; 2012.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
Abstract
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).
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Pascal:12-0305302Le document en format XML
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<author><name sortKey="Vignes, Stephane" sort="Vignes, Stephane" uniqKey="Vignes S" first="Stephane" last="Vignes">Stephane Vignes</name>
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<author><name sortKey="Arrault, Maria" sort="Arrault, Maria" uniqKey="Arrault M" first="Maria" last="Arrault">Maria Arrault</name>
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<author><name sortKey="Vignes, Stephane" sort="Vignes, Stephane" uniqKey="Vignes S" first="Stephane" last="Vignes">Stephane Vignes</name>
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<series><title level="j" type="main">Journal of plastic, reconstructive & aesthetic surgery </title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm</term>
<term>Breast</term>
<term>Breast cancer</term>
<term>Lymphedema</term>
<term>Plasty</term>
<term>Surgery</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Cancer du sein</term>
<term>Lymphoedème</term>
<term>Plastie</term>
<term>Traitement</term>
<term>Chirurgie</term>
<term>Sein</term>
<term>Bras</term>
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<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term>
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<front><div type="abstract" xml:lang="en">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).</div>
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<name sortKey="Vignes, Stephane" sort="Vignes, Stephane" uniqKey="Vignes S" first="Stephane" last="Vignes">Stephane Vignes</name>
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