Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap
Identifieur interne : 002118 ( Pmc/Curation ); précédent : 002117; suivant : 002119Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap
Auteurs : Kyeong Tae Lee [Corée du Sud] ; So-Young Lim [Corée du Sud] ; Jai-Kyung Pyun [Corée du Sud] ; Goo-Hyun Mun [Corée du Sud] ; Kap-Sung Oh [Corée du Sud] ; Sa-Ik Bang [Corée du Sud]Source :
- Archives of Plastic Surgery [ 2234-6163 ] ; 2012.
Abstract
Lymphedema is a common complication after mastectomy in breast cancer patients. Many treatment options are available, but no treatment results in a complete cure. We report a case of lymphedema that occurred after modified radical mastectomy in a breast cancer patient who showed objective improvement after delayed breast reconstruction with an latissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer had undergone modified radical mastectomy with axillary lymph node dissection and postoperative radiotherapy 12 years previously. Four years after surgery, lymphedema developed and increased in aggravation despite conservative treatment. Eight years after the first operation, the patient underwent delayed breast reconstruction using the extended latissimus dorsi myocutaneous flap method. After reconstruction, the patient's lymphedema symptoms showed dramatic improvement by subjective measures including tissue softness and feeling of lightness, and by objective measures of about 7 mL per a week, resulting in near normal ranges of volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayed breast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful to patients with lymphedema after mastectomy. This may be a good option for patients who are worried about the possibility of the occurrence or aggravation of secondary lymphedema.
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DOI: 10.5999/aps.2012.39.2.154
PubMed: 22783516
PubMed Central: 3385318
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level="a" type="main">Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap</title><author><name sortKey="Lee, Kyeong Tae" sort="Lee, Kyeong Tae" uniqKey="Lee K" first="Kyeong Tae" last="Lee">Kyeong Tae Lee</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Lim, So Young" sort="Lim, So Young" uniqKey="Lim S" first="So-Young" last="Lim">So-Young Lim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Pyun, Jai Kyung" sort="Pyun, Jai Kyung" uniqKey="Pyun J" first="Jai-Kyung" last="Pyun">Jai-Kyung Pyun</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Mun, Goo Hyun" sort="Mun, Goo Hyun" uniqKey="Mun G" first="Goo-Hyun" last="Mun">Goo-Hyun Mun</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Oh, Kap Sung" sort="Oh, Kap Sung" uniqKey="Oh K" first="Kap-Sung" last="Oh">Kap-Sung Oh</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Bang, Sa Ik" sort="Bang, Sa Ik" uniqKey="Bang S" first="Sa-Ik" last="Bang">Sa-Ik Bang</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea></affiliation></author></analytic><series><title level="j">Archives of Plastic Surgery</title><idno type="ISSN">2234-6163</idno><idno type="eISSN">2234-6171</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Lymphedema is a common complication after mastectomy in breast cancer patients. Many treatment options are available, but no treatment results in a complete cure. We report a case of lymphedema that occurred after modified radical mastectomy in a breast cancer patient who showed objective improvement after delayed breast reconstruction with an latissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer had undergone modified radical mastectomy with axillary lymph node dissection and postoperative radiotherapy 12 years previously. Four years after surgery, lymphedema developed and increased in aggravation despite conservative treatment. Eight years after the first operation, the patient underwent delayed breast reconstruction using the extended latissimus dorsi myocutaneous flap method. After reconstruction, the patient's lymphedema symptoms showed dramatic improvement by subjective measures including tissue softness and feeling of lightness, and by objective measures of about 7 mL per a week, resulting in near normal ranges of volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayed breast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful to patients with lymphedema after mastectomy. This may be a good option for patients who are worried about the possibility of the occurrence or aggravation of secondary lymphedema.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chang, Dw" uniqKey="Chang D">DW Chang</name></author><author><name sortKey="Kim, S" uniqKey="Kim S">S Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Starritt, Ec" uniqKey="Starritt E">EC Starritt</name></author><author><name sortKey="Joseph, D" uniqKey="Joseph D">D Joseph</name></author><author><name sortKey="Mckinnon, Jg" uniqKey="Mckinnon J">JG McKinnon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Erickson, Vs" uniqKey="Erickson V">VS Erickson</name></author><author><name sortKey="Pearson, Ml" uniqKey="Pearson M">ML Pearson</name></author><author><name sortKey="Ganz, Pa" uniqKey="Ganz P">PA Ganz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abbas Khan, Ma" uniqKey="Abbas Khan M">MA Abbas Khan</name></author><author><name sortKey="Mohan, A" uniqKey="Mohan A">A Mohan</name></author><author><name sortKey="Hardwicke, J" uniqKey="Hardwicke J">J Hardwicke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ozaslan, C" uniqKey="Ozaslan C">C Ozaslan</name></author><author><name sortKey="Kuru, B" uniqKey="Kuru B">B Kuru</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sakorafas, Gh" uniqKey="Sakorafas G">GH Sakorafas</name></author><author><name sortKey="Peros, G" uniqKey="Peros G">G Peros</name></author><author><name sortKey="Cataliotti, L" uniqKey="Cataliotti L">L Cataliotti</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johansen, J" uniqKey="Johansen J">J Johansen</name></author><author><name sortKey="Overgaard, J" uniqKey="Overgaard J">J Overgaard</name></author><author><name sortKey="Blichert Toft, M" uniqKey="Blichert Toft M">M Blichert-Toft</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Slavin, Sa" uniqKey="Slavin S">SA Slavin</name></author><author><name sortKey="Upton, J" uniqKey="Upton J">J Upton</name></author><author><name sortKey="Kaplan, Wd" uniqKey="Kaplan W">WD Kaplan</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Arch Plast Surg</journal-id><journal-id journal-id-type="iso-abbrev">Arch Plast Surg</journal-id><journal-id journal-id-type="publisher-id">APS</journal-id><journal-title-group><journal-title>Archives of Plastic Surgery</journal-title></journal-title-group><issn pub-type="ppub">2234-6163</issn><issn pub-type="epub">2234-6171</issn><publisher><publisher-name>The Korean Society of Plastic and Reconstructive Surgeons</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22783516</article-id><article-id pub-id-type="pmc">3385318</article-id><article-id pub-id-type="doi">10.5999/aps.2012.39.2.154</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Kyeong Tae</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Lim</surname><given-names>So-Young</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Pyun</surname><given-names>Jai-Kyung</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Mun</surname><given-names>Goo-Hyun</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Oh</surname><given-names>Kap-Sung</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Bang</surname><given-names>Sa-Ik</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib></contrib-group><aff id="A1">Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</aff><author-notes><corresp>Correspondence: Sa-Ik Bang. Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-2-3410-2235, Fax: +82-2-3410-0036, <email>sibang55@samsung.com</email></corresp></author-notes><pub-date pub-type="ppub"><month>3</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>14</day><month>3</month><year>2012</year></pub-date><volume>39</volume><issue>2</issue><fpage>154</fpage><lpage>157</lpage><history><date date-type="received"><day>01</day><month>10</month><year>2011</year></date><date date-type="rev-recd"><day>01</day><month>11</month><year>2011</year></date><date date-type="accepted"><day>02</day><month>11</month><year>2011</year></date></history><permissions><copyright-statement>Copyright © 2012 The Korean Society of Plastic and Reconstructive Surgeons</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Lymphedema is a common complication after mastectomy in breast cancer patients. Many treatment options are available, but no treatment results in a complete cure. We report a case of lymphedema that occurred after modified radical mastectomy in a breast cancer patient who showed objective improvement after delayed breast reconstruction with an latissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer had undergone modified radical mastectomy with axillary lymph node dissection and postoperative radiotherapy 12 years previously. Four years after surgery, lymphedema developed and increased in aggravation despite conservative treatment. Eight years after the first operation, the patient underwent delayed breast reconstruction using the extended latissimus dorsi myocutaneous flap method. After reconstruction, the patient's lymphedema symptoms showed dramatic improvement by subjective measures including tissue softness and feeling of lightness, and by objective measures of about 7 mL per a week, resulting in near normal ranges of volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayed breast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful to patients with lymphedema after mastectomy. This may be a good option for patients who are worried about the possibility of the occurrence or aggravation of secondary lymphedema.</p></abstract><kwd-group><kwd>Breast reconstruction</kwd><kwd>Pedicled flap</kwd><kwd>Lymphedema</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" position="float"><label>Fig. 1</label><caption><p>Preoperative status</p><p>A 41-year-old female patient had received a modified radical mastectomy and postoperative radiotherapy 12 years previously for left breast cancer. Four years after surgery, postmastectomy lymphedema developed in her left hand and forearm.</p></caption><graphic xlink:href="aps-39-154-g001"></graphic></fig><fig id="F2" position="float"><label>Fig. 2</label><caption><p>Postoperative 2 months status</p><p>The patient's lymphedema symptoms began to improve by subjective measures at 2 months after the breast reconstruction, and after 4 months, the degree of improvement was observed by the objective assessment.</p></caption><graphic xlink:href="aps-39-154-g002"></graphic></fig><fig id="F3" position="float"><label>Fig. 3</label><caption><p>Volume change after breast reconstruction</p><p>The graph shows the dramatic decrease of arm volume after delayed breast reconstruction with extended latissimus dorsi myocutaneous flap. ELD, extended latissimus dorsi myocutaneous flap.</p></caption><graphic xlink:href="aps-39-154-g003"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Volume measurement of both arms using volumetry</p></caption><graphic xlink:href="aps-39-154-i001"></graphic><table-wrap-foot><fn><p>Delayed breast reconstruction with extended latissimus dorsi myocutaneous flap were performed at 27 months after lymphedema onset.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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