par

Hot Keywords
Abdominal wall reconstruction Dermal fillers Facial rejuvenation Abdominoplasty Blepharoplasty Body contouring Flap Breast surgery Fat grafting Cleft lip Hair transplantation Hand surgery Materials Microsurgery Neck rejuvenation Reconstructive surgery Wound healing Peripheral nerve repair Limb preservation

Top
Plast Aesthet Res 2016;3:320.10.20517/2347-9264.2016.71© 2016 OAE Publishing Inc.
Open AccessCommentary

Comment on “Breast cancer-related lymphedema: quality of life after lymph node transfer”

Affiliates in Plastic Surgery, Mclean, VA 22101, USA.

Correspondence Address: Dr. Azra Ashraf, Affiliates in Plastic Surgery, Mclean, VA 22101, USA. E-mail: azra.ashraf@gmail.com

    Views:166082 | Downloads:1766 | Cited:0 | Comments:0 | :0
    ...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License (http://creativecommons.org/licenses/by-nc-sa/3.0/), which allows others to remix, tweak and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

    As plastic surgeons, improvements in quality of life are often the goal of our labor. As the vascularized lymph node transfer (VLNT) procedure continues to evolve to become the surgical solution for lymphedema, proving the efficacy not only as a technique, but equally as important, its impact on quality of life is pivotal. De Brucker et al.[1] elegantly demonstrates quality improvements during a 29-month postoperative duration through a validated survey (Upper Limb Lymphedema-27 Questionnaire).

    Although I largely agree with the results and the study design, I speculate recall bias may be high. In this study, patients received 2 Upper Limb Lymphedema-27 Questionnaires postoperatively. Though the surveys were identical, one was to be completed based on the patients’ pre-operative status (a duration of up to 5 years previously). In addition, 22 patients of the 25 patients underwent simultaneous procedures (DIEP & lymph node transfer), combining the risk, morbidity and ultimately the patient’s experience of 2 separate procedures. This may have implications in recall bias because of the resultant limitation when comparing seemingly identical procedures. Though it is certainly reasonable to perform lymph node transfer simultaneously as part of breast reconstruction, when attempting to study the experiential effect of lymph node transfer in situ, it’s difficult to delineate.

    In my experience, breast reconstruction is an integral component of patients’ wellbeing. With the prevalence of breast cancer-related lymphedema up to 49%,[2] it is critical we seek a surgical solution. As the field of lymph node transfer continues to mature your study is the first to demonstrate an improvement in quality of life via a validated survey and furthermore sets the foundation that VLNT improves wellbeing and functionality in this patient population.

    Financial support and sponsorship

    None.

    Conflicts of interest

    There are no conflicts of interest.

    Patient consent

    Not involved.

    Ethics approval

    Not involved.

    References

    • 1. De Brucker B, Zeltzer A, Seidenstuecker K, Hendrickx B, Adriaenssens N, Hamdi M. Breast cancer-related lymphedema: quality of life after lymph node transfer. Plast Reconstr Surg 2016;137:1673-80.

      DOIPubMed
    • 2. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R. A randomized comparison of sentinel node biopsy with routine axillary dissection in breast cancer. N Engl J Med 2003;349:546-53.

      DOIPubMed

    Cite This Article

    Ashraf A. Comment on “Breast cancer-related lymphedema: quality of life after lymph node transfer”. Plast Aesthet Res 2016;3:320-1 . http://dx.doi.org/10.20517/2347-9264.2016.71

    Views
    166082
    Downloads
    1766
    Citations
     0
    Comments
    0

    0

    Download and Bookmark

    Download

    Download PDF Add to Bookmark

    Share This Article

    Article Access Statistics

    Full-Text Views Each Month

    PDF Downloads Each Month

    Comments

    Comments must be written in English. Spam, offensive content, impersonation, and private information will not be permitted. If any comment is reported and identified as inappropriate content by OAE staff, the comment will be removed without notice. If you have any queries or need any help, please contact us at support@oaepublish.com.

    © 2016-2021 OAE Publishing Inc., except certain content provided by third parties