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Ashraf. Plast Aesthet Res 2016;3:320-1 Plastic and
DOI: 10.20517/2347-9264.2016.71
Aesthetic Research

www.parjournal.net
Commentary Open Access

Comment on “Breast cancer-related

lymphedema: quality of life after lymph

node transfer”

Azra Ashraf

Affiliates in Plastic Surgery, Mclean, VA 22101, USA.
Correspondence to: Dr. Azra Ashraf, Affiliates in Plastic Surgery, Mclean, VA 22101, USA. E-mail: azra.ashraf@gmail.com
How to 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.
Article history: Received: 26-08-2016 Accepted: 06-09-2016 Published: 30-09-2016

As plastic surgeons, improvements in quality of life are simultaneously as part of breast reconstruction, when
often the goal of our labor. As the vascularized lymph attempting to study the experiential effect of lymph node
node transfer (VLNT) procedure continues to evolve transfer in situ, it’s difficult to delineate.
to become the surgical solution for lymphedema,
proving the efficacy not only as a technique, but In my experience, breast reconstruction is an integral
equally as important, its impact on quality of life is component of patients’ wellbeing. With the prevalence
pivotal. De Brucker et al. elegantly demonstrates of breast cancer-related lymphedema up to 49%, it is
[1]
[2]
quality improvements during a 29-month postoperative critical we seek a surgical solution. As the field of lymph
duration through a validated survey (Upper Limb node transfer continues to mature your study is the first
Lymphedema-27 Questionnaire). to demonstrate an improvement in quality of life via a
validated survey and furthermore sets the foundation
Although I largely agree with the results and the study that VLNT improves wellbeing and functionality in this
design, I speculate recall bias may be high. In this patient population.
study, patients received 2 Upper Limb Lymphedema-27
Questionnaires postoperatively. Though the surveys Financial support and sponsorship
were identical, one was to be completed based on None.
the patients’ pre-operative status (a duration of up to
5 years previously). In addition, 22 patients of the Conflicts of interest
25 patients underwent simultaneous procedures There are no conflicts of interest.
(DIEP & lymph node transfer), combining the risk,
morbidity and ultimately the patient’s experience of 2 Patient consent
separate procedures. This may have implications in Not involved.
recall bias because of the resultant limitation when
comparing seemingly identical procedures. Though it Ethics approval
is certainly reasonable to perform lymph node transfer Not involved.

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