Patient History - The inspiration for the survey
We were recently sent the following history and subsequent question. There is very little information available to answer this question. I think this is an important question, especially as more women are asking their doctors about lymphedema.
The letter to us read: (name withheld per request)
A patient with bilateral mastectomy (1982 & 1987) and no
reconstruction, with left arm/hand lymphedema (wearing a ReidSleeveŽ at night)
that has become mild, and minor (if any) lymphedema in right arm (no
treatment), what are the risks of the various kinds of breast reconstruction
vis-ā-vis aggravating lymphedema. The left arm/hand lymphedema began in 1992
(10 years post mastectomy, after a plane flight), and originally she wore
ill-fitting Jobst sleeve/gauntlet and battled swollen, achy, painful
lymphedema (never described as anything but "Stage 1+", but painful and
scary nevertheless). During surgery, 25 lymph nodes were removed from left
axilla; 12 were removed from right (all benign, but she had chemotherapy due to
tumor size/pathology).
The ReidSleeveŽ brought the best relief/result, but the problem has been
chronic, and we do not have anyone in St. Louis very qualified to treat
lymphedema. So, the control of lymphedema has been HARD WON, and not
something she wants to disturb. But breast reconstruction is something she
would love to have.
Statement of confidentiality: All information in this survey will be used as
statistical data only. Any information that identifies an individual person
will not be disclosed without prior written approval from the provider.
Instructions: Please answer each question based on the standard answers to the
best of your ability. If the question does not apply please proceed to the
next question.