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Current Breast Cancer Reports

20-03-2024 | Lymphedema | Review

Surgical Management of Lymphedema: Prophylactic and Therapeutic Operations

Authors: Shahnur Ahmed, Folasade O. Imeokparia, Aladdin H. Hassanein

Published in: Current Breast Cancer Reports

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Abstract

Purpose of Review

Lymphedema is a chronic limb swelling caused by lymphatic dysfunction and is currently incurable. Breast cancer–related lymphedema (BCRL) affects up to 5 million Americans and occurs in one-third of breast cancer survivors following axillary lymph node dissection. Compression remains the mainstay of therapy. Surgical management of BCRL includes excisional procedures to remove excess tissue and physiologic procedures to attempt to improve fluid retention in the limb. The purpose of this review is to highlight surgical management strategies for preventing and treating breast cancer–related lymphedema.

Recent Findings

Immediate lymphatic reconstruction (ILR) is a microsurgical technique that anastomoses disrupted axillary lymphatic vessels to nearby veins at the time of axillary lymph node dissection (ALND) and has been reported to reduce lymphedema rates from 30 to 4–12%.

Summary

Postsurgical lymphedema remains incurable. Surgical management of lymphedema includes excisional procedures and physiologic procedures using microsurgical technique. Immediate lymphatic reconstruction has emerged as a prophylactic strategy to prevent lymphedema in breast cancer patients.
Literature
1.
2.
3.
4.
5.
6.
7.
8.
9.
Smeltzer DM, Stickler GB, Schirger A. Primary lymphedema in children and adolescents: a follow-up study and review. Pediatrics. 1985;76(2):206–18.PubMed
10.
11.
van der Putte SC, van Limborgh J. The embryonic development of the main lymphatics in man. Acta Morphol Neerl Scand. 1980;18(4):323–35.PubMed
12.
13.
International Society of L. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology. 2013;46(1):1–11.
14.
15.
16.
17.
18.
Hayes SC, Johansson K, Stout NL, Prosnitz R, Armer JM, Gabram S, Schmitz KH. Upper-body morbidity after breast cancer: incidence and evidence for evaluation, prevention, and management within a prospective surveillance model of care. Cancer. 2012;118(8 Suppl):2237–49. https://​doi.​org/​10.​1002/​cncr.​27467.CrossRefPubMed
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med. 2003;44(1):43–57.PubMed
38.
Executive Committee of the International Society of L. The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology. 2020;53(1):3–19.
39.
Sander AP, Hajer NM, Hemenway K, Miller AC. Upper-extremity volume measurements in women with lymphedema: a comparison of measurements obtained via water displacement with geometrically determined volume. Phys Ther. 2002;82(12):1201–12.CrossRefPubMed
40.
41.
42.
Ridner SH, Montgomery LD, Hepworth JT, Stewart BR, Armer JM. Comparison of upper limb volume measurement techniques and arm symptoms between healthy volunteers and individuals with known lymphedema. Lymphology. 2007;40(1):35–46.PubMed
43.
44.
45.
46.
Johansson K, Lie E, Ekdahl C, Lindfeldt J. A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Lymphology. 1998;31(2):56–64.PubMed
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
Crowley JS, Liu FC, Rizk NM, Nguyen D. Concurrent management of lymphedema and breast reconstruction with single-stage omental vascularized lymph node transfer and autologous breast reconstruction: A case series. Microsurgery. 2023. https://​doi.​org/​10.​1002/​micr.​31017.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
Sakurai T, Endo M, Shimizu K, Yoshimizu N, Nakajima K, Nosaka K, et al. Axillary reverse mapping using fluorescence imaging is useful for identifying the risk group of postoperative lymphedema in breast cancer patients undergoing sentinel node biopsies. J Surg Oncol. 2014;109(6):612–5. https://​doi.​org/​10.​1002/​jso.​23528.CrossRefPubMed
79.
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
Metadata
Title
Surgical Management of Lymphedema: Prophylactic and Therapeutic Operations
Authors
Shahnur Ahmed
Folasade O. Imeokparia
Aladdin H. Hassanein
Publication date
20-03-2024
Publisher
Springer US
Published in
Current Breast Cancer Reports
Print ISSN: 1943-4588
Electronic ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-024-00543-4
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