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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2017

01-06-2017 | Reconstructive Oncology

Clinical and Psychosocial Outcomes of Vascularized Lymph Node Transfer for the Treatment of Upper Extremity Lymphedema After Breast Cancer Therapy

Authors: Andrew Gratzon, MD, Jerette Schultz, BS, Kristine Secrest, OTR/L, CLT-LANA, Kenneth Lee, MD, FACS, Jeffrey Feiner, MD, Richard D. Klein, MD, MPH, FACS

Published in: Annals of Surgical Oncology | Issue 6/2017

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ABSTARCT

Background

Secondary lymphedema following breast cancer therapy remains a major problem. Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema that has shown promising results, but limited studies in the United States have investigated outcomes for single-stage VLNT to the axilla. The goal of this prospective, ongoing study was to investigate the clinical, psychosocial, and functional outcomes of patients who underwent VLNT for the treatment of upper extremity lymphedema after breast cancer therapy.

Study Design

VLNT to the axilla were performed on patients with upper extremity lymphedema after breast cancer therapy. Patients were evaluated preoperatively and postoperatively at 1-, 3-, 6-, 9-, and 12-month intervals by circumferential measurements, pain/heaviness scales, and the LYMQOL questionnaire.

Results

Fifty patients met the study criteria. Preliminary results showed a decrease in arm volumes by 34.57 % at 1 month, 52.03 % at 3 months, 42.34 % at 6 months, 65.23 % at 9 months, and 58.68 % at 12 months. Pain and heaviness consistently decreased over time to 0.38 and 1.67 respectively at 12 months. Overall quality of life scores steadily improved from 5.72 preoperatively to 7.79 at 12 months. There was a significant decrease in the number of infections of the affected arm postoperatively and a decreased need for physiotherapy. Complications occurred in 17 patients and consisted mainly of minor wound complications.

Conclusions

VLNT continues to demonstrate its value as a safe and effective treatment option for lymphedema after breast cancer therapy. Significant reductions in volume are accompanied by a decrease in symptoms and improvement in quality of life.
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Metadata
Title
Clinical and Psychosocial Outcomes of Vascularized Lymph Node Transfer for the Treatment of Upper Extremity Lymphedema After Breast Cancer Therapy
Authors
Andrew Gratzon, MD
Jerette Schultz, BS
Kristine Secrest, OTR/L, CLT-LANA
Kenneth Lee, MD, FACS
Jeffrey Feiner, MD
Richard D. Klein, MD, MPH, FACS
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5614-4

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