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Surgical Prevention of Arm Lymphedema After Breast Cancer Treatment

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

Abstract

Purpose

To prospectively assess the efficacy of the lymphatic microsurgical preventive healing approach (LYMPHA) to prevent lymphedema after axillary dissection (AD) for breast cancer treatment.

Methods

Among 49 consecutive women referred from March 2008 to September 2009 to undergo complete AD, 46 were randomly divided in 2 groups. Twenty-three underwent the LYMPHA technique for the prevention of arm lymphedema. The other 23 patients had no preventive surgical approach (control group). The LYMPHA procedure consisted of performing lymphatic-venous anastomoses (LVA) at the time of AD. All patients underwent preoperative lymphoscintigraphy (LS). Patients were followed up clinically at 1, 3, 6, 12, and 18 months by volumetry. Postoperatively, LS was performed after 18 months in 41 patients (21 treatment group and 20 control group). Arm volume and LS alterations were assessed.

Results

Lymphedema appeared in 1 patient in the treatment group 6 months after surgery (4.34%). In the control group, lymphedema occurred in 7 patients (30.43%). No statistically significant differences in the arm volume were observed in the treatment group during follow-up, while the arm volume in the control group showed a significant increase after 1, 3, and 6 months from operation. There was significant difference between the 2 groups in the volume changes with respect to baseline after 1, 3, 6, 12, and 18 months after surgery (every timing P value < 0.01).

Conclusions

LYMPHA represents a valid technique for primary prevention of secondary arm lymphedema with no risk of leaving undetected malignant disease in the axilla.

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Authors and Affiliations

  1. Department of Surgery, Unit of Lymphatic Surgery, S. Martino Hospital, University of Genoa, Genoa, Italy

    Francesco M. Boccardo MD & Corradino Campisi MD

  2. Department of Obstetrics and Gynecology, S. Martino Hospital, University of Genoa, Genoa, Italy

    Federico Casabona MD

  3. Department of Surgery, Breast Unit, S. Martino Hospital, University of Genoa, Genoa, Italy

    Daniele Friedman MD & Maria Puglisi MD

  4. Department of Surgery, Unit of Oncologic Surgery, S. Martino Hospital, University of Genoa, Genoa, Italy

    Franco De Cian MD

  5. Department of Health Science and Statistics, S. Martino Hospital, University of Genoa, Genoa, Italy

    Filippo Ansaldi MD

Authors
  1. Francesco M. Boccardo MD
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  2. Federico Casabona MD
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  3. Daniele Friedman MD
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  4. Maria Puglisi MD
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  5. Franco De Cian MD
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  6. Filippo Ansaldi MD
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  7. Corradino Campisi MD
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Corresponding author

Correspondence to Francesco M. Boccardo MD.

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Boccardo, F.M., Casabona, F., Friedman, D. et al. Surgical Prevention of Arm Lymphedema After Breast Cancer Treatment. Ann Surg Oncol 18, 2500–2505 (2011). https://doi.org/10.1245/s10434-011-1624-4

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  • DOI: https://doi.org/10.1245/s10434-011-1624-4

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