In a nutshell
This paper studied the risk of lymphedema associated with immediate breast reconstruction compared to mastectomy (removal of entire breast) alone.
Some background
While improvements in breast cancer treatment have led to better survival, there are still side effects of treatment. Lymphedema, the chronic swelling of arms, body and limbs, can be a side effect of breast cancer treatment. This can affect quality of life.
More and more patients are also receiving immediate breast reconstruction (procedure to rebuild breast) after a mastectomy. Studies have suggested that delayed breast reconstruction can reduce risk of lymphedema. However, there has not been any study done comparing mastectomy plus immediate breast reconstruction with mastectomy alone.
Methods & findings
616 patients with breast cancer who underwent mastectomy were analyzed. They were followed-up after their surgery for an average of 22.2 months. Of 891 mastectomies, 76% had immediate breast reconstruction and 24% had no reconstruction.
The 2-year occurrence of lymphedema was 10.58% in those who had immediate breast reconstruction and 26.6% in those who did not have reconstruction. The 2-year occurrence of lymphedema was 4.08% in those who had an implant reconstruction (using implants) compared with 9.89% in those who had autologous reconstruction (using tissues from other parts of body). Immediate breast reconstruction was associated with a 57% reduced risk of lymphedema. In particular, implant reconstruction showed significant reduced risk of lymphedema but autologous reconstruction did not.
The bottom line
The authors suggested that immediate implant reconstruction had a reduced risk of lymphedema compared to mastectomy.
The fine print
Differences among patient groups could affect the results.
Published By :
Annals of Surgery
Date :
Jan 20, 2015
