- Lymphedema has long been a feared complication of surgical cancer treatment, and notably one that negatively impacts survivorship Overall incidence of lymphedema is 16.3% after melanoma, 10.1 % after genitourinary cancers, 19.6% after gynecologic malignancy.
- The incidence of breast cancer-related lymphedema has been difficult to quantify due to delayed onset of symptoms and the lack of standardized diagnostic criteria. A recent meta-analysis reports the incidence of breast cancer-related lymphedema to range from 0 to 3% after lumpectomy alone to as high as 65% to 70% after modified radical mastectomy with regional nodal radiation. Overall, 80% to 90% of women who will develop lymphedema do so within 3 years of treatment, but the risks persist years later as the remaining 10% to 20% will develop lymphedema at a rate of 1% per year.One study followed 263 patients and found that nearly 50% developed lymphedema by 20 years.
We offer two surgical options to treat lymphedema:
- Vascularized lymph node transfer surgery: This is an intricate microsurgical procedure used to treat patients with advanced lymphedema affecting the skin tissue in the arms or legs. A plastic surgeon transfers working lymph nodes from another part of the body, typically the upper groin, submandibular, omentum, or lower abdomen, to the damaged site. We then divide the existing blood vessels that supply the nodes and connect them at the site where the lymph nodes are needed. We use reverse lymphatic mapping to reduce the chance of lymphedema occurring in the areas where lymph nodes were harvested.
- Lymphaticovenular bypass surgery: This surgery is an intricate super-microsurgical procedure used to treat patients with mild to moderate lymphedema. Our plastic surgeons perform the surgery by shunting, or moving, fluid from several dilated lymphatics in the affected limb to adjacent venules (tiny veins) to reduce pressure