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

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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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Authors and Affiliations

  1. Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

    Julia A. Cook MD, Scott N. Loewenstein MD, Will DeBrock MD, Mary Lester MD, Juan Socas MD, Carla S. Fisher MD & Aladdin H. Hassanein MD, MMSc

  2. Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

    Sarah E. Sasor MD

  3. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

    Kandice K. Ludwig MD

Authors
  1. Julia A. Cook MD
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  2. Sarah E. Sasor MD
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  3. Scott N. Loewenstein MD
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  4. Will DeBrock MD
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  5. Mary Lester MD
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  6. Juan Socas MD
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  7. Kandice K. Ludwig MD
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  8. Carla S. Fisher MD
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  9. Aladdin H. Hassanein MD, MMSc
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Corresponding author

Correspondence to Aladdin H. Hassanein MD, MMSc.

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Cook, J.A., Sasor, S.E., Loewenstein, S.N. et al. Immediate Lymphatic Reconstruction after Axillary Lymphadenectomy: A Single-Institution Early Experience. Ann Surg Oncol 28, 1381–1387 (2021). https://doi.org/10.1245/s10434-020-09104-2

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  • DOI: https://doi.org/10.1245/s10434-020-09104-2

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