Lymphedema is a disease in which the lymphatic drainage in part of the body is disrupted and that body part undergoes chronic swelling. In some patients with breast cancer, the lymph nodes in the armpit are found to have cancer cells. If this is the case, the lymph nodes are usually removed as part of the cancer treatment. When that is done, lymphedema is one of the potential complications. Upper extremity lymphedema occurs in 20-30% of women who undergo removal of lymph nodes for the treatment of breast cancer. This number is likely higher in patients who also require radiation therapy. Read further for the new LYMPHA for lymphedema treatment.
LYMPHA: A Lymphedema Treatment
In an effort to reduce the risk of developing lymphedema after the removal of lymph nodes, we perform a procedure to reconstruct the lymphatic system called LYMPHA. This is done as a preventative treatment (eg prior to the development of symptoms of lymphedema). The lymphatic channels that are divided during the removal of the lymph nodes are reconnected to a small vein in the armpit. With armpit lymph node removal, the risk for upper extremity lymphedema can be up to 30%. LYMPHA decreases the risk of developing lymphedema to less than 10%.
During LYMPHA Surgery
LYMPHA is performed on the same day that the lymph nodes are removed from the armpit. Your surgeon will inject blue dye into the arm near the elbow to identify the lymphatic channels. The lymphatic channels that are divided during the removal of the lymph nodes are connected to a vein in the armpit with the use of a microscope. This procedure adds approximately 1 hour to your surgery. It is performed through the same incision used for the removal of the lymph nodes. The lymphatic channels and veins that are joined are structures that were already divided during the removal of lymph nodes. No additional structures are injured, and no additional incisions are required.
After LYMPHA for lymphedema, you will have restrictions on the range of motion of the shoulder, in order to protect the tiny connection between the lymphatic channels and veins. You will have regular checkups with your plastic surgeon to monitor for the development of lymphedema in the arm. Although the risk of lymphedema is significantly decreased, unfortunately, there is still a small risk of developing lymphedema over time. By identifying any signs of lymphedema early, we can start treatment as soon as possible to minimize symptoms.