Characterizing Trends of Lymphedema After Axillary Lymph Node Dissection with and Without Immediate Lymphatic...

Area of Science:

• Oncology
• Surgical Innovation
• Lymphedema Management

Background:

• Breast cancer-related lymphedema (BCRL) is a debilitating complication following axillary lymph node dissection (ALND).
• Axillary lymph node dissection (ALND) is a standard procedure for breast cancer staging and treatment.
• Developing effective preventative strategies for BCRL is crucial for improving patient quality of life.

Purpose of the Study:

• To evaluate the efficacy of immediate lymphatic reconstruction (ILR) in preventing breast cancer-related lymphedema (BCRL) after ALND.
• To compare the incidence and onset of BCRL in patients who underwent ALND with versus without ILR.
• To identify factors influencing lymphedema development post-ALND.

Main Methods:

• Retrospective single-institution study involving 186 patients undergoing ALND.
• Bioimpedance and limb measurements were used to diagnose BCRL.
• Statistical analysis included Pearson's chi-square test and multivariable logistic regression to compare outcomes between ALND with and without ILR.

Main Results:

• Immediate lymphatic reconstruction (ILR) was performed in 44 patients (24%), while 142 (76%) did not undergo ILR.
• Patients receiving ILR had a 64% lower odds of developing BCRL compared to those undergoing ALND alone.
• The mean number of lymphatic bypasses created during ILR was 3.54.
• Lymphedema onset was delayed by approximately 8 months in the ILR group if BCRL developed.

Conclusions:

• Immediate lymphatic reconstruction (ILR) is associated with significantly lower rates of breast cancer-related lymphedema (BCRL) after axillary lymph node dissection (ALND).
• ILR may serve as a protective measure against the early onset of BCRL.
• Further research can explore long-term outcomes and refine ILR techniques.