Breast reconstruction and risk of lymphedema after mastectomy: A prospective cohort study with 10 years of follow-up
| Autor: | Marcelo Adeodato Bello, Eduardo Camargo Millen, Frederico A.S. Lucas, Monique M. Menezes, Mauro Andrade, Rosalina Jorge Koifman, Flávia Nascimento de Carvalho, Ana Carolina Padula Ribeiro Pereira, Anke Bergmann |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Pathological staging medicine.medical_treatment Mammaplasty Breast Neoplasms 030230 surgery Single Center 03 medical and health sciences 0302 clinical medicine Risk Factors Medicine Humans Lymphedema Prospective Studies Prospective cohort study Mastectomy Neoplasm Staging business.industry Incidence (epidemiology) Middle Aged medicine.disease Surgery 030220 oncology & carcinogenesis BRASIL Female business Breast reconstruction Cohort study Follow-Up Studies Forecasting |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 1878-0539 |
| Popis: | Summary 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. |
| Databáze: | OpenAIRE |
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