Sloan Kettering: TE implants don't increase risk of LE

kira66715

Found this on pubmed, at Sloan Kettering, they seem to have an awfully low rate of LE--why does this not concur with the experience of the women on these boards?:

http://www.ncbi.nlm.nih.gov/pubmed/20499284 

Ann Surg Oncol. 2010 Nov;17(11):2926-32. Epub 2010 May 25.
Tissue expander breast reconstruction is not associated with an increased risk of lymphedema.
Avraham T, Daluvoy SV, Riedel ER, Cordeiro PG, Van Zee KJ, Mehrara BJ.
Source
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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.

PMID: 20499284 [PubMed - indexed for MEDLINE]