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A 4-Year Institutional Experience of Immediate Lymphatic Reconstruction
Melisa D Granoff1, Aaron Fleishman2, Kathy Shillue3
1From the Division of Plastic and Reconstructive Surgery.
Plastic and Reconstructive Surgery
|March 6, 2023
Summary
Immediate lymphatic reconstruction (ILR) significantly reduces breast cancer-related lymphedema (BCRL) risk in high-risk patients. This study confirms ILR
Area of Science:
- Oncology
- Surgical Innovation
- Lymphedema Research
Background:
- Breast cancer treatment can lead to lymphedema in up to one-third of patients.
- Immediate lymphatic reconstruction (ILR) shows early promise in preventing lymphedema.
- Limited long-term data exists due to ILR's recent adoption and varied institutional criteria.
Purpose of the Study:
- To evaluate the long-term incidence of breast cancer-related lymphedema (BCRL) in patients who underwent immediate lymphatic reconstruction (ILR).
- To assess the efficacy of ILR in a high-risk patient cohort over an extended follow-up period.
Main Methods:
- Retrospective review of patients undergoing ILR from September 2016 to September 2020.
- Inclusion criteria: preoperative measurements, minimum 6-month follow-up, and completed lymphovenous bypass.
- Data collected: demographics, cancer treatment, intraoperative details, and lymphedema incidence.
Main Results:
- 186 patients with unilateral node-positive breast cancer underwent axillary surgery and attempted ILR.
- 90 patients met eligibility criteria for successful ILR (mean age 54 ± 12.1 years).
- Overall lymphedema incidence was 9% after a median follow-up of 17 months.
Conclusions:
- Immediate lymphatic reconstruction (ILR) at the time of axillary lymph node dissection is effective.
- ILR significantly reduces the risk of BCRL in high-risk breast cancer patients.
- Long-term follow-up supports ILR as a valuable preventative procedure.
