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Is cellulitis of a reconstructed breast (after breast cancer) common?
I have gotten cellulitis of my reconstructed breast three times in the last six months. The first time I was hospitalized for a week. I was very sick and it was very painful. Is this a common occurrence?
asked Sep 16, 2010 at 07:09PM in Oncology/Cancer
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According to recent literature emerging from Finland and elsewhere (e.g. Rönkä 2004-5, Leidenius 2005) the incidence of breast lymphedema (sometimes called "delayed breast cellulitis" in the literature) is as high as 23% clinical presentation and over 70% subclinical. The cause is not restricted to surgery, but includes breast irradiation which causes fibrosing in the breast skin and reduced lymphatic transport. Patients with breast lymphedema are at great risk for recurrent cellulitis. Please contact me privately at LymphActivist@aol.com and I will send you a poster on the subject.Robert Weiss MS commented Oct 19, 2010 at 11:08PM
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2Votes
answered Sep 17, 2010 at 10:09AMCellulitis is an inflammatory reaction involving
the skin and underlying subcutaneous
tissue. Patients who undergo
surgery for breast cancer, whether in the
setting of breast conservation or mastectomy, are at
risk of developing infection at the surgical site and
in soft tissue. Surgical trauma predisposes patients
to skin infection by breaching normal tissue barriers.
The widespread use of antibiotic prophylaxis
has reduced, but not eliminated, infections associated
with surgical intervention. Postoperative skin
infections develop after 2%–7% of all surgical procedures;
there is, however, considerable variation
according to the type of surgery being performed,
the duration of the operation, and the presence of
comorbid illnesses.1 The incidence of surgical site
infections is 12.4% following mastectomy with immediate
implant reconstruction, 6.2% following
mastectomy with immediate reconstruction using
a transverse rectus abdominis myocutaneous
flap, and 4.4% following mastectomy only.2 The
reported incidence following breast-conserving
therapy ranges from 2.5% to 14%.
REF: http://www.supportiveoncology.net/journal/articles/0705174.pdf-
what do you recommend I do? I have had my onco say I should get the implant removed (maybe cleaned up in there) but my plastic surgeon feels that is not necesssary.Although he did not know about the 3rd occurance. Any thoughts? thanks for the infoStephanie Joelle MacNeil commented Sep 17, 2010 at 03:08PM
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What is the long-term incidence of breast lymphedema after these surgical procedures? A DIEP flap reconstruction with lymphatic reconnection has been shown to reduce the rate of breast and arm lymphedema.Robert Weiss MS commented Oct 19, 2010 at 11:19PM
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0Votesanswered Sep 18, 2010 at 04:47AMDear Stephanie.
Sorry but I can not recommend any conduct for you because it would be wrong on my part. It would not be ethical.
For any disease you should think at least on what are the chances of cure and risk of complications.
Again sorry.
Mario.
* See the article http://emedicine.medscape.com/article/781412-overview
Cellulitis
Author: Danny Lee Curtis, MD, Assistant Clinical Professor of Medicine, University of South Florida School of Medicine, Consulting Staff, James A. Haley Veterans' Hospital, Tampa, Florida -
0Votesanswered Sep 18, 2010 at 07:09AMI do understand that sir. I just wanted your opinion. I have one doc saying one thing and another saying something different. "take out" : "do not take out it is fine" I am just looking for advice. or even if others have experienced this and what they did about it. remember... mine has came back 3 times in 5 months. I want to get my last stage of my reconstruction (nipple and tattooing) and this is now put on hold. I have had many complications throughout this journey and it sucks. I had 6 surgeries in 08 due to complicatons and now I am dealing with this. thanks for all the help.
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0Votesanswered Sep 18, 2010 at 07:44AMDear Stephanie.
Perhaps the question that has to answer is:
- The inflammation / infection - cellulitis will be resolved with the clinical and drug treatment. YES or NO.
Again, For any disease you Should think at least on what are the chances of cure and risk of complications. And what is the correct treatment is a medical issue and very personal (medical history and physical examination, etc.) in accordance with the limitations of the patient.
I'm sorry but I can not go beyond.
Mario.
** I sincerely hope (from the heart) that everything will be resolved as best as possible for you. -
2Votes
answered Sep 18, 2010 at 08:15AMCellulitis after reconstruction is not common, but it does occur. When it does it can be a vexing problem. It can also be confused with inflammation or lymphedema of the reconstructed tissue.
I would ask your physician if there may be some component of lymphedema associated with your reconstruction. There are a few reports of Hyperbaric Oxygen being an effective treatment for lymphedema in problem breast cases, and it may be helpful with your reconstruction "flap" infections as well.
You may want to consult a certified wound care specialist or center to have this evaluated.-
Thanks for the comments and help in showing a way.Mário Rodrigues Montemor Netto MD commented Sep 18, 2010 at 08:28AM
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I agree with your comment that it may be breast lymphedema or inflammation, and add the suggestion that you consult a QUALIFIED lymphedema specialist for evaluation and potential treatment suggestions. Manual lymph drainage and compression garments may be indicated to reduce the edema and the risk of cellulitis.Robert Weiss MS commented Oct 19, 2010 at 11:14PM
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0Votes
answered Oct 20, 2010 at 12:27AMI agree with Dr. McGlone's comment that it may be breast lymphedema or inflammation, and add the suggestion that you consult a QUALIFIED lymphedema specialist for evaluation and potential treatment suggestions. Manual lymph drainage and compression garments may be indicated to reduce the edema and the risk of cellulitis.
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