Five-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1–4N1–3M0 Breast Cancer

Background Breast cancer-related lymphedema (BCRL) is a source of postoperative morbidity for breast cancer survivors. Lymphatic microsurgical preventive healing approach (LYMPHA) is a technique used to prevent BCRL at the time of axillary lymph node dissection (ALND). We report the 5-year experienc...

Full description

Saved in:
Bibliographic Details
Published in:Annals of surgical oncology 2021-10, Vol.28 (10), p.5775-5787
Main Authors: Herremans, Kelly M., Cribbin, Morgan P., Riner, Andrea N., Neal, Dan W., Hollen, Tracy L., Clevenger, Pamela, Munoz, Derly, Blewett, Shannon, Giap, Fantine, Okunieff, Paul G., Mendenhall, Nancy P., Bradley, Julie A., Mendenhall, William M., Mailhot-Vega, Raymond B., Brooks, Eric, Daily, Karen C., Heldermon, Coy D., Marshall, Julia K., Hanna, Mariam W., Leyngold, Mark M., Virk, Sarah S., Shaw, Christiana M., Spiguel, Lisa R.
Format: Article
Language:English
Subjects:
Anastomosis
Axilla
Body mass index
Breast cancer
Breast Neoplasms - surgery
Breast Oncology
Female
Humans
Lymph Node Excision - adverse effects
Lymph nodes
Lymphedema
Lymphedema - etiology
Lymphedema - prevention & control
Lymphedema - surgery
Medicine
Medicine & Public Health
Morbidity
Oncology
Patients
Quality of Life
Retrospective Studies
Risk factors
Sentinel Lymph Node Biopsy
Surgeons
Surgery
Surgical Oncology
Surveillance
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Breast cancer-related lymphedema (BCRL) is a source of postoperative morbidity for breast cancer survivors. Lymphatic microsurgical preventive healing approach (LYMPHA) is a technique used to prevent BCRL at the time of axillary lymph node dissection (ALND). We report the 5-year experience of a breast surgeon trained in LYMPHA and investigate the outcomes of patients who underwent LYMPHA following ALND for treatment of cT1–4N1–3M0 breast cancer. Methods A retrospective review of patients with cT1–4N1–3M0 breast cancer was performed in patients who underwent ALND with and without LYMPHA. Diagnosis of BCRL was made by certified lymphedema therapists. Descriptive statistics and lymphedema surveillance data were analyzed using results of Fisher’s exact or Wilcoxon rank-sum tests. Logistic regression and propensity matching were performed to assess the reduction of BCRL occurrence following LYMPHA. Results In a 5-year period, 132 patients met inclusion criteria with 76 patients undergoing LYMPHA at the time of ALND and 56 patients undergoing ALND alone. Patients who underwent LYMPHA at the time of ALND were significantly less likely to develop BCRL than those who underwent ALND alone ( p  = 0.045). Risk factors associated with BCRL development were increased patient age ( p  = 0.007), body mass index (BMI) ( p = 0.003), and, in patients undergoing LYMPHA, number of positive nodes ( p  = 0.026). Conclusions LYMPHA may be successfully employed by breast surgeons trained in lymphatic–venous anastomosis at the time of ALND. While research efforts should continue to focus on prevention and surveillance of BCRL, LYMPHA remains an option to reduce BCRL and improve patient quality of life.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-021-10551-8