Outcomes After Perforator Flap Reconstruction for Breast Reconstruction and/or Lymphedema Treatment

Study Overview
=================
Brief Summary
-----------------
The goal of this prospective, observational study is to investigate the clinical, psychosocial, and patient satisfaction outcomes of patients who undergo perforator flap reconstruction for breast reconstruction and/or vascularized lymph node transfer (VLNTx) for the treatment of lymphedema. The investigators hypothesize that (1) perforator flap breast reconstruction will result in excellent clinical, psychosocial, and patient satisfaction outcomes compared to non-perforator flap breast reconstruction; (2) perforator flap breast reconstruction is associated with less persistent postsurgical pain than other forms of breast reconstruction, even after controlling for major cofactors, such as the extent of auxiliary lymph node dissection and the use of radiation therapy; (3) perforator flap reconstruction for the treatment of Lymphedema (i.e., VLNTx ) will result in the reduction of symptoms and complications of lymphedema.

Detailed Description
-----------------
Breast cancer is a serious health issue that affects 1 in 8 women. Although numerous treatments have arisen in recent years to aggressively combat this disease and increase survivorship, many survivors develop a crippling condition that can result in devastating physical and psychological impairments. Breast reconstruction by any method may help recovery psychologically. However, some individuals still report experiencing pain following their recovery from surgery. Additionally, secondary lymphedema is a common yet poorly understood complication of breast cancer patients. For those individuals who undergo axillary lymph node dissection the rates of incidence of lymphedema approach 47%. These rates tend to increase further for patients who receive irradiation treatment or mastectomies. Currently there is no known cure for lymphedema. Current treatments include non-invasive measures as well as surgical interventions. Vascularized lymph node transfer (VLNTx) is a fairly recent surgical procedure that has shown promising results. The goal of this research study is to analyze the clinical outcome of subjects who undergo breast reconstruction with perforator flaps and/or VLNTx using information collected as part of standard care. Clinical data will be collected prospectively. All subjects who undergo a surgical procedure will complete the online persistent postsurgical pain assessment questionnaire. The BreastQ questionnaire will be completed by patients prior to and after undergoing breast reconstruction and/or lymphedema treatment.

Official Title
-----------------
Outcomes After Perforator Flap Reconstruction for Breast Reconstruction and/or Lymphedema Treatment

Conditions
-----------------
Breast Cancer, Hereditary Breast/Ovarian Cancer (brca1, brca2), Acquired Lymphedema, Congenital Lymphedema

Intervention / Treatment
-----------------
* Procedure: Perforator Flap Breast Reconstruction
* Procedure: Vascularized Lymph Node Transfer


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Undergoing perforator flap surgery for breast reconstruction and/or vascularized lymph node transfer for treatment of lymphedema Exclusion Criteria: Pregnant unable to read

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Perforator Flap Breast Reconstruction<br>Patients who undergo perforator flap breast reconstruction with or without concomitant vascularized lymph node transfer | Procedure: Perforator Flap Breast Reconstruction<br>* perforator flap breast reconstruction with or without vascularized lymph node transfer<br>* Other names: ICP Flap;Procedure: Vascularized Lymph Node Transfer<br>* perforator flap vascularized lymph node transfer with or without concomitant perforator flap breast reconstruction<br>* Other names: VLNTx;|
| Vascularized Lymph Node Transfer<br>Patients who undergo perforator flap vascularized lymph node transfer with or without concomitant perforator flap breast reconstruction | Procedure: Perforator Flap Breast Reconstruction<br>* perforator flap breast reconstruction with or without vascularized lymph node transfer<br>* Other names: ICP Flap;Procedure: Vascularized Lymph Node Transfer<br>* perforator flap vascularized lymph node transfer with or without concomitant perforator flap breast reconstruction<br>* Other names: VLNTx;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in BreastQ Questionnaire and Lymphedema Severity Score |  | Baseline and 6 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Persistent Postsurgical Pain assessment questionnaire |  | 6 months after surgery | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Breast Cancer, BRACA1/2 Genotype, Acquired Lymphedema, Congenital Lymphedema