Effectiveness of the lymphatic microsurgical preventive healing approach for avoiding breast cancer-related arm lymphedema
Recommended Citation
Yono SS, Hannoudi A, Chamseddine H, Rama S, Bensenhaver JM, Yoho D, Tepper D, Evangelista MS, Nathanson SD, and Atisha DM. Effectiveness of the lymphatic microsurgical preventive healing approach for avoiding breast cancer-related arm lymphedema. Breast 2025;83:104540.
Document Type
Article
Publication Date
7-14-2025
Publication Title
Breast (Edinburgh, Scotland)
Abstract
BACKGROUND: There is currently no proven surgical approach that prevents breast cancer related arm lymphedema (BCRAL). We hypothesized that the lymphatic microsurgical preventive healing approach (LyMPHA) during axillary lymph node dissection (ALND) could reduce BCRAL development.
STUDY DESIGN: We conducted a single-center retrospective cohort study of patients with breast cancer who underwent ALND with or without immediate LyMPHA between 2016 and 2022. Primary outcomes were development of BCRAL and quality of life measures within 4 years of surgery. Secondary outcomes were days to drain removal and postoperative complications. Kaplan-Meier analysis determined risk of BCRAL over time. Cox regression analysis was used to determine risk factors associated with development of BCRAL.
RESULTS: Of 187 patients who underwent ALND, 121 (64.7 %) received LyMPHA and 66 (35.3 %) underwent ALND only. The mean age was 56.4 ± 13.6 years. Patients who underwent LyMPHA had lower risk of lymphedema over time (p = 0.003), lower median percent functional impairment (4.7 % vs 11.6 %, p = 0.045), and shorter median drain duration (13.0 vs 15.0 days; p = 0.042). Regression analysis showed that those who received LyMPHA were half as likely to develop BCRAL (hazard ratio 0.53; 95 % CI 0.28-0.98; p = 0.043). Groups did not differ in the rate of postoperative complications. No other factors were associated with BCRAL, including age, body mass index, smoking status, or history of other cancer therapies.
CONCLUSION: Performing immediate lymphatic reconstruction with LyMPHA after ALND may prevent arm lymphedema and reduce morbidity in patients with breast cancer.
Medical Subject Headings
Humans; Female; Middle Aged; Retrospective Studies; Lymph Node Excision/methods/adverse effects; Breast Neoplasms/surgery; Microsurgery/methods; Breast Cancer Lymphedema/prevention & control/etiology; Aged; Arm; Axilla/surgery; Adult; Postoperative Complications/prevention & control/etiology; Quality of Life; Lymphedema/prevention & control/etiology; Risk Factors; Lymphatic Vessels/surgery; Treatment Outcome; Kaplan-Meier Estimate; Alnd; Bcral; Llis; LyMPHA
PubMed ID
40682911
Volume
83
First Page
104540
Last Page
104540
