loading
Advances in Breast Reconstruction Improve Breast Cancer Staging PRMA Plastic Surgery

Advances in Breast Reconstruction Improve Breast Cancer Staging

Advances in Breast Reconstruction Improve Breast Cancer Staging PRMA Plastic Surgery

How can breast reconstruction improve breast cancer staging?

Breast cancer comes in all shapes, sizes and stages. To effectively treat breast cancer, it is essential the cancer is accurately evaluated and “staged.” Breast cancer staging is based on the make-up of the tumor, lymph node involvement and metastasis throughout the body.

For most breast cancer patients, only axillary lymph nodes are biopsied and tested to determine lymph node involvement during breast cancer surgery. Patients with more advanced stage cancers, partly based on lymph node involvement, may benefit from adjuvant therapies such as chemotherapy and/or radiation. However, internal mammary lymph nodes (which are responsible for up to 30% of lymphatic drainage of the breast) are typically not dissected for staging evaluation due to limited access to the nodes during routine breast cancer surgery.

Research performed at PRMA Plastic Surgery has shown that although rare, internal mammary lymph node metastases may be identified safely at the time of free flap breast reconstruction procedures. Through internal mammary lymph node biopsy, a more comprehensive evaluation and more accurate staging of the breast cancer is made possible.

During free flap reconstruction procedures like the DIEP flap, the internal mammary lymph nodes are routinely exposed during the recipient blood vessel dissection. Once visible, the nodes can easily be dissected without adding any significant surgery time or risks to the patient.

Breast cancer metastasis to the internal mammary lymph nodes is associated with a worse prognosis than those with only axillary lymph node involvement. This is why we believe taking the extra time to biopsy the internal mammary nodes during free flap breast reconstruction is important for accurate staging of a patient’s breast cancer to ensure they receive the best treatment for their individual diagnosis.

Research Breakdown:

Among the 2,057 patients who underwent internal mammary lymph node biopsy during free flap breast reconstruction, 28 were found to have breast cancer metastasis in these nodes.

Out of the 28 patients who were found to have metastasis, 50% had already undergone chemotherapy treatment, and 53.6% had prior radiation therapy.

Of the 28 patients that were found to harbor internal mammary lymph node metastases, 10 patients did not have any metastases identified in their axillary lymph nodes. Without an internal mammary lymph node biopsy, these patients risked being undertreated due to incomplete staging information. Ultimately, 17 out of 28 patients (63%) had a change in cancer therapy based solely on the results of the internal mammary lymph node biopsy.

Author: Dr. Minas Chrysopoulo and Courtney Floyd

Internal_Mammary_Lymph_Node_Biopsy_During_Free-Flap_Breast_Reconstruction__Optimizing_Adjuvant_Breast_Cancer_Treatment_Through_Comprehensive_Staging

Research performed at PRMA Plastic Surgery shows advances in microsurgical breast reconstruction have facilitated a more comprehensive evaluation for lymphatic staging of breast cancer.

Sign Up for Our Monthly Newsletter

Online Form – Newsletter Signup

Continue Reading

Breast Reconstruction Surgery and Your Period

Breast Reconstruction Surgery and Your Period

Breast Reconstruction Surgery and Your Period December 02, 2020 Share on Facebook Twitter Linkedin During our pre-operative appointment with patients, a topic that occasionally arises is menstrual cycles.  It is completely normal for women to experience changes with their periods throughout breast cancer treatments.  These can be temporary or permanent.  Periods can be unpredictable following […]

Read More

What Bras and Abdominal Girdles to Wear After Breast Reconstruction Surgery

What Bras and Abdominal Girdles to Wear After Breast Reconstruction Surgery November 17, 2020 Share on Facebook Twitter Linkedin When preparing for breast reconstruction surgery, many patients want to know what types of bras and abdominal girdles they should plan to wear after surgery. Although every surgeon has slightly different preferences, we have put together […]

Read More

My 5 DIEP Flap Realities | A Guest Blog From Julie

My 5 DIEP Flap Realities October 28, 2020 Share on Facebook Twitter Linkedin Hi everyone, my name is Julie from It’s a Bosom Thing. I am so happy to be here as a guest blogger and have this opportunity to share with you a few thoughts about life after DIEP Flap Surgery. I was diagnosed […]

Read More

bra day 2020

PRMA’s BRA Day Virtual Event Recap

PRMA’s BRA Day Virtual Event Recap September 08, 2020 Share on Facebook Twitter Linkedin Yesterday we celebrated Breast Reconstruction Awareness day! Although we missed seeing everyone in person this year, we were still able to spread education and awareness on ALL reconstructive options through our virtual efforts.  We were also able to share information on […]

Read More

Second Stage DIEP Flap Surgery

Second Stage DIEP Flap Surgery

Second Stage DIEP Flap Surgery September 08, 2020 Share on Facebook Twitter Linkedin DIEP flap breast reconstruction is typically comprised of at least two stages for the best outcomes.  The second stage of surgery is commonly referred to as the “revision” stage and is usually performed about three months after the initial reconstruction.  The purpose […]

Read More

flaps good option for breast reconstruction_ PRMA Plastic Surgery

If ‘Flaps’ Are Such A Great Breast Reconstruction Option, Why Doesn’t Everyone Get Them?

If ‘Flaps’ Are Such A Great Breast Reconstruction Option, Why Doesn’t Everyone Get Them? September 08, 2020 Share on Facebook Twitter Linkedin Flap-based breast reconstruction procedures, like the DIEP flap, offer patients a safe, natural implant-alternative option to reconstruction after a mastectomy.  Flap surgeries are permanent and are associated with fewer complications after radiation when […]

Read More

Skin Island in Breast Reconstruction _ PRMA Plastic Surgery

What is a Skin Island and How is it Used in Breast Reconstruction?

What is a Skin Island and How is it Used in Breast Reconstruction? September 08, 2020 Share on Facebook Twitter Linkedin What is a “skin island”? The term “skin island” is used to describe the remaining visible skin from a transplanted “flap” of tissue. In the setting of DIEP flap breast reconstruction, the skin island […]

Read More

comparing apex and diep flap

Comparing APEX Flap and DIEP Flap Breast Reconstruction

Comparing APEX Flap and DIEP Flap Breast Reconstruction August 10, 2020 Share on Facebook Twitter Linkedin We have been receiving numerous inquiries about the “APEX flap” recently.  Patients want to know what it is and how it differs from the DIEP flap. APEX is an acronym that stands for “Abdominal Perforator Exchange”.  Many patients believe […]

Read More

Monitoring the Health of Your Flap During & After Surgery PRMA Plastic Surgery

Monitoring the Health of Your Flap During & After Surgery

Monitoring the Health of Your Flap During & After Surgery July 21, 2020 Share on Facebook Twitter Linkedin Autologous flap (or tissue) breast reconstruction procedures represent today’s most advanced options for rebuilding a breast(s) following mastectomy. The most commonly performed method of flap-based reconstruction at PRMA is the DIEP flap. During this procedure, surgeons transplant skin […]

Read More

COVID-19 and the Impact on Cancer Patient’s Mortality PRMA Plastic Surgery

COVID-19 and the Impact on Cancer Patient’s Mortality

COVID-19 and the Impact on Cancer Patient’s Mortality July 21, 2020 Share on Facebook Twitter Linkedin There is still so much we do not know about COVID-19. Likewise, there is little known about how this disease impacts mortality for cancer patients. A study published in The Lancet evaluated and characterized the outcomes of patients with cancer […]

Read More

post-img
Prev post

​Reducing Hospital Stay After Free Flap Breast Reconstruction

Next post

A Word of Caution on FDA Approved At-Home Breast Cancer Gene Testing

post-img