Tissue expander breast reconstruction is not associated with an increased risk of lymphedema Journal Article


Authors: Avraham, T.; Daluvoy, S. V.; Riedel, E. R.; Cordeiro, P. G.; Van Zee, K. J.; Mehrara, B. J.
Article Title: Tissue expander breast reconstruction is not associated with an increased risk of lymphedema
Abstract: Background: Recent reports have demonstrated that lymphedema can occur after even minor pertubation of the axillary region such as sentinel lymph node biopsy (SLNB). The impact of breast reconstruction on the development of lymphedema, however, remains unknown. Therefore, the purpose of this study was to determine the impact of immediate tissue expander breast reconstruction on the risk of developing lymphedema. Materials and Methods: We identified patients who had undergone mastectomy with SLNB or SLNB and axillary lymph node dissection (ALND) with or without breast reconstruction using our prospectively maintained lymphedema and breast reconstruction databases. The development of lymphedema was evaluated prospectively using arm measurements and a validated questionnaire. Associations between variables were examined. Logistic regression was used to examine the association of reconstruction on prevalence of lymphedema while adjusting individually for BMI, age, and weight gain after surgery. Results: Characteristics of patients with or without reconstruction were similar except for age, BMI, and weight gain since surgery. Median follow-up was 5 years. Among patients treated with mastectomy with SLNB or SLNB/ALND, those undergoing reconstruction had a lower rate of measured lymphedema than those who did not (5% vs. 18%, P < .0004). The reconstructed group also had fewer patients with both measured and self-reported lymphedema (3% vs. 12%, P < .002). Differences in the rates of measured lymphedema between groups persisted following univariate logistical regression for differences in age, BMI, and weight gain. Conclusions: Tissue expander breast reconstruction in patients undergoing SLNB or SLNB/ALND does not increase the risk of developing measured or perceived lymphedema. © 2010 Society of Surgical Oncology.
Keywords: major clinical study; clinical trial; lymph node dissection; prospective study; sentinel lymph node biopsy; disease association; mastectomy; breast reconstruction; risk assessment; self report; lymphedema; axillary lymph node; body mass; breast endoprosthesis; logistic regression analysis; univariate analysis; weight gain
Journal Title: Annals of Surgical Oncology
Volume: 17
Issue: 11
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2010-11-01
Start Page: 2926
End Page: 2932
Language: English
DOI: 10.1245/s10434-010-1112-2
PROVIDER: scopus
PUBMED: 20499284
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: ASONF" - "Source: Scopus"
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MSK Authors
  1. Kimberly J Van Zee
    289 Van Zee
  2. Sanjay Daluvoy
    17 Daluvoy
  3. Babak Mehrara
    400 Mehrara
  4. Peter G Cordeiro
    278 Cordeiro
  5. Tomer Avraham
    33 Avraham