Precis Future Med.  2020 Jun;4(2):53-59. 10.23838/pfm.2020.00065.

Breast cancer related lymphedema and surgical treatment

Affiliations
  • 1Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

Abstract

Lymphedema is a chronic, progressive and debilitating disease. This review article focuses on surgical treatment of breast cancer-related lymphedema especially in perspectives of microsurgical options. In the early stage, where protein-rich fluid accumulates, expressed as pitting, conservative treatments, such as complex decongestive therapy and/or one of the physiologic treatments, lymphovenous bypass (LVB) can be considered. Once the stage is more advanced and skin fibrosis and adipose tissue deposition are appearing, it may be considered to attempt vascularized lymph node transplant (VLNT) alone or VLNT and LVB simultaneously. If the stage is more advanced and fibroadipose tissue accumulation is dominant, then debulking procedure such as liposuction may be considered. A direct excision may be needed for the most advanced stage of lymphedema.

Keyword

Breast neoplasms; Lymphedema; Therapeutics; Upper extremity
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