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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2021

01-03-2021 | Lymphedema | Breast Oncology

Immediate Lymphatic Reconstruction after Axillary Lymphadenectomy: A Single-Institution Early Experience

Authors: Julia A. Cook, MD, Sarah E. Sasor, MD, Scott N. Loewenstein, MD, Will DeBrock, MD, Mary Lester, MD, Juan Socas, MD, Kandice K. Ludwig, MD, Carla S. Fisher, MD, Aladdin H. Hassanein, MD, MMSc

Published in: Annals of Surgical Oncology | Issue 3/2021

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Abstract

Purpose

Lymphedema is progressive arm swelling from lymphatic dysfunction which can occur in 30% patients undergoing axillary dissection/radiation for breast cancer. Immediate lymphatic reconstruction (ILR) is performed in an attempt decrease the risk of lymphedema in patients undergoing axillary lymph node dissection (ALND). The purpose of this study was to assess the efficacy of ILR in preventing lymphedema rates in ALND patients.

Methods

An institutional review board-approved retrospective review was performed of all patients who underwent ILR from 2017 to 2019. Patient demographics, comorbidities, operative and pathologic findings, number of LVAs, limb measurements, complications, and follow-up were recorded and analyzed. Student’s sample t-test, Fisher’s exact test, and ANOVA were used to analyze data; significance was set at p < 0.05.

Results

Thirty-three patients were included in this analysis. Three patients (9.1%) developed persistent lymphedema, and two patients (6.1%) developed transient arm edema that resolved with compression and massage therapy. A significant effect was found for body mass index and the number of lymph nodes taken on the development of lymphedema (p < 0.01).

Conclusions

The rate of lymphedema in this series was 9.1%, which is an improvement from historical rates of lymphedema. Our findings support ILR as a technique that potentially decreases the incidence of lymphedema after axillary lymphadenectomy. Obesity and number of lymph nodes removed were significant predictive variables for the development of lymphedema following LVA.
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Metadata
Title
Immediate Lymphatic Reconstruction after Axillary Lymphadenectomy: A Single-Institution Early Experience
Authors
Julia A. Cook, MD
Sarah E. Sasor, MD
Scott N. Loewenstein, MD
Will DeBrock, MD
Mary Lester, MD
Juan Socas, MD
Kandice K. Ludwig, MD
Carla S. Fisher, MD
Aladdin H. Hassanein, MD, MMSc
Publication date
01-03-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09104-2

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