title: Positive impact of delayed breast reconstruction on breast-cancer treatment-related arm lymphoedema.
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.
  
  
  CONCLUSIONS
  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).
authors.affiliation: Department of Lymphology, Hôpital Cognacq-Jay, 15, rue Eugène Millon, 75015 Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Blanchard
authors.forename: Maria
authors.initials: M
authors.lastname: Arrault
authors.forename: Stéphane
authors.initials: S
authors.lastname: Vignes
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006225:Hand; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013524:Surgical Flaps; D013997:Time Factors