Monique M Menezes1, Marcelo A Bello2, Eduardo Millen3, Frederico A S Lucas4, Flávia N Carvalho5, Mauro F C Andrade6, Ana Carolina P R Pereira7, Rosalina J Koifman8, Anke Bergmann9. 1. Centro Universitário Augusto Motta, Programa de Pós-Graduação em Ciências da Reabilitação, Rio de Janeiro, Brazil. Electronic address: moniquemaron@gmail.com. 2. Instituto Nacional de Câncer, Hospital do Câncer III, Rio de Janeiro, Brazil. Electronic address: mabello@inca.gov.br. 3. Instituto Nacional de Câncer, Hospital do Câncer III, Rio de Janeiro, Brazil. Electronic address: eduardomillen@uol.com.br. 4. Instituto Nacional de Câncer, Hospital do Câncer III, Rio de Janeiro, Brazil. Electronic address: fredericolucas@uol.com.br. 5. Instituto Nacional de Câncer, Hospital do Câncer III, Rio de Janeiro, Brazil. Electronic address: fcarvalho@inca.gov.br. 6. Faculdade de Medicina da Universidade de São Paulo, Laboratório de Anatomia Médico Cirúrgica, São Paulo, Brazil. Electronic address: mauroand@uol.com.br. 7. Escola Nacional de Saúde Publica Sergio Arouca, Programa de Pós-Graduação em Saúde Pública e Meio Ambiente, Rio de Janeiro, Brazil. Electronic address: carol_padula@hotmail.com. 8. Escola Nacional de Saúde Publica Sergio Arouca, Programa de Pós-Graduação em Saúde Pública e Meio Ambiente, Rio de Janeiro, Brazil. Electronic address: rosalina.koifman@hotmail.com. 9. Instituto Nacional de Câncer, Programa de Carcinogese Molecular, Rio de Janeiro, Brazil. Electronic address: abergmann@inca.gov.br.
Abstract
OBJECTIVE: The aim of this study is to assess the incidence and risk factors for lymphedema in women submitted to mastectomy, with or without breast reconstruction. METHODS: A cohort study was performed on women submitted to mastectomy with axillary lymphadenectomy in a single center. The follow-up included clinical evaluation and arm column measurements before surgery, at 30 days, 6 months, 5 years, and 10 years after surgery. For women subjected to late reconstruction, the time of occurrence of lymphedema (before or after reconstruction) was observed. RESULTS: We followed up on 622 patients submitted to mastectomy and axillary lymphadenectomy for an average period of 57 months after surgery. In total, 94 women were submitted to breast reconstruction, 47 (8%) of them immediate and 47 (8%) late reconstructions. Incidence of lymphedema in the whole group was 33% (n = 204). Among the patients submitted to reconstruction, 28% of them developed lymphedema, on average, 93 months (CI 95%, 88-98) after surgical treatment. In women not subjected to reconstruction, 179 (34%) developed lymphedema, on average, after 106 months (CI 95%, 96-116) (p = 0.03). Breast reconstruction reduced lymphedema risk in 36% (HR = 0.64, CI 96%, 0.42-0.98, p = 0.04). After adjustment for pathological staging and radiotherapy, this was not statistically significant (HR = 0.79, CI 95%, 0.52-1.21, p = 0.28). CONCLUSION: Breast reconstruction does not increase the risk of lymphedema in long-term follow-up.
OBJECTIVE: The aim of this study is to assess the incidence and risk factors for lymphedema in women submitted to mastectomy, with or without breast reconstruction. METHODS: A cohort study was performed on women submitted to mastectomy with axillary lymphadenectomy in a single center. The follow-up included clinical evaluation and arm column measurements before surgery, at 30 days, 6 months, 5 years, and 10 years after surgery. For women subjected to late reconstruction, the time of occurrence of lymphedema (before or after reconstruction) was observed. RESULTS: We followed up on 622 patients submitted to mastectomy and axillary lymphadenectomy for an average period of 57 months after surgery. In total, 94 women were submitted to breast reconstruction, 47 (8%) of them immediate and 47 (8%) late reconstructions. Incidence of lymphedema in the whole group was 33% (n = 204). Among the patients submitted to reconstruction, 28% of them developed lymphedema, on average, 93 months (CI 95%, 88-98) after surgical treatment. In women not subjected to reconstruction, 179 (34%) developed lymphedema, on average, after 106 months (CI 95%, 96-116) (p = 0.03). Breast reconstruction reduced lymphedema risk in 36% (HR = 0.64, CI 96%, 0.42-0.98, p = 0.04). After adjustment for pathological staging and radiotherapy, this was not statistically significant (HR = 0.79, CI 95%, 0.52-1.21, p = 0.28). CONCLUSION: Breast reconstruction does not increase the risk of lymphedema in long-term follow-up.
Authors: Antonio J Forte; Andrea Sisti; Maria T Huayllani; Daniel Boczar; Gabriela Cinotto; Pedro Ciudad; Oscar J Manrique; Xiaona Lu; Sarah McLaughlin Journal: Gland Surg Date: 2020-04