ObjectiveTo review the progress of treatment and prevention of breast cancer related lymphedema. MethodsThe recent literature concerning treatment and prevention of breast cancer related lymphedema was extensively consulted and reviewed. ResultsThe treatment of lymphedema is now based on complete decongestive therapy, supplemented with medicine and surgery. Those procedures have been proved to be safe and effective. Sentinel lymph node biopsy, axillary reverse mapping, and lymphaticovenous anastomoses have been used to decrease the incidence of lymphedema. They show promising effectiveness in short term, but the long-term effectiveness needs further tests. ConclusionIn clinical practice, many treatment methods are used to decrease lymphedema, and lymphedema prevention is playing an increasingly important role. Lymphaticovenous anastomoses shows a promising effectiveness in reducing lymphedema.
ObjectiveTo explore the method of implant coverage with local soft tissue in immediate implant-based breast reconstruction and to evaluate the early effectiveness. MethodsBetween April 2014 and August 2015, 11 patients with breast cancer underwent immediate breast reconstruction with implants after mastectomy, and the clinical data were reviewed retrospectively. The age ranged 29-48 years (mean, 36 years). The disease duration was from 7 days to 12 months (median, 3 months). According to tumor staging, 3 cases were rated as TisN0M0, 4 cases as T1N0M0, and 4 cases as T2N0M0. The implants were covered with local soft tissue according to the volume of mastectomy and contralateral breast size, including pectoralis major myocutaneous flaps with inframammary adipofasical flaps (3 cases), with serratus anterior fascial flap (5 cases), with rectus sheath fascial flap (1 case), and with serratus anterior fascial flap and rectus sheath fascial flap (2 cases). The size of pectoralis major myocutaneous flaps ranged from 15 cm×9 cm to 20 cm×15 cm, and the serratus anterior fascial flaps from 10 cm×8 cm to 15 cm×10 cm, and the rectus sheath fascial flap from 8 cm×6 cm to 10 cm×8 cm. ResultsOne patient had partial nipple necrosis postoperatively and was cured, and no other postoperative complications of hematoma, infection, or implant exposure was found. The patients were followed up 4-13 months (median, 8 months). The reconstructive outcomes were excellent in 10 cases and good in 1 case, with an excellent and good rate of 100%. During follow-up, no rupture or exposure of the implant was observed; capsular contracture (Baker grade II) occurred in 1 case. ConclusionAdequate coverage of implants with different local soft tissue flaps can achieve satisfactory early effectiveness in immediate implant-based breast reconstruction after mastectomy.
ObjectiveTo explore the techniques and short-term effectivness of contralateral breast symmetrization mammaplasty in breast reconstruction. MethodsBetween February 2014 and December 2015, 11 patients received immediate or delayed breast reconstruction after nipple-sparing mastectomy (6 and 5 cases respectively) for contralateral breast symmetrization mammaplasty. The age ranged 36-55 years (mean, 45 years). The disease duration was from 7 days to 6 months (mean, 2.5 months) in 6 patients undergoing immediate breast reconstruction. According to tumor TNM staging, 2 cases were rated as TisN0M0, 3 cases as T1N0M0, and 1 case as T2N0M0. The duration was from 2 to 25 years (mean, 8 years) in 5 patients undergoing delayed breast reconstruction. The implant (7 cases) and latissimus dorsi (4 cases) were used for breast reconstruction; and breast augmentation (6 cases) and breast reduction (5 cases) were performed for contralateral breast symmetrization. ResultsOne patient had local poor wound healing postoperatively and was cured; primary healing was obtained in the other patients, and no other postoperative complication of infection, implant exposure or capsular contracture was found. The patients were followed up 3 to 24 months (mean, 12 months). The reconstructive outcomes were excellent in 9 cases and good in 2 cases, with an excellent and good rate of 100%. There was no recurrence or metastasis. ConclusionSimultaneous contralateral symmetrization with augmentation/reduction mammaplasty after breast reconstruction can obtain satisfactory symmetric outcomes.