Plastic & Reconstructive
Surgery: June 2016 - Volume 137 - Issue
6 - p 1673–1680
De Brucker, B et al
Background: Breast cancer–related lymphedema affects
multiple aspects of patients’ daily lives. The main aim of this study was to
assess the impact of vascularized lymph node transfer on the quality of life in
patients with lymphedema. Methods: Between 2007 and 2012, 25 female patients
with breast cancer–related lymphedema underwent vascularized lymph node
transfer. In 22 cases, the patients underwent a simultaneous deep inferior
epigastric artery perforator flap breast reconstruction based on the
superficial circumflex iliac artery. The influence on quality of life was
evaluated using the Upper Limb Lymphedema-27 questionnaire, which includes
physical, psychological, and social dimensions. The authors also investigated
risk factors for lymphedema, such as body mass index, smoking, age, and time
between start of lymphedema and vascularized lymph node transfer, and their
impact on quality of life. Results: Twenty-one patients (84 percent) had an
improvement of quality of life after vascularized lymph node transfer. The mean
physical, psychological, and social scores were significantly improved
postoperatively (p < 0.001). Risk factors for the development of lymphedema
did not influence quality of life among patients with breast cancer–related
lymphedema. Skin infections disappeared in 50 percent of the cases. Eleven
patients (44 percent) discontinued compression therapy at a mean postoperative
time interval of 29 months (range, 8 to 64 months). In the other patients (56
percent), the average frequency of compression therapy decreased from three
sessions to one session per week. Conclusion: Vascularized lymph node transfer
significantly improves quality of life among patients with breast
cancer–related lymphedema.
