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Breast Cancer-Related Lymphedema

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Breast Cancer Management for Surgeons

Abstract

Lymphedema is a common long-term complication of breast cancer treatment with a significant impact on quality of life and possibly life-threatening consequences. Major risks factors are axillary lymph node dissection, radiation and obesity. Early detection and treatment may limit progressive arm volume increase. Conservative treatment consists of weight reduction/control, exercise, skin care and compression garments. Some patients may benefit from decongestive lymphatic therapy if the symptoms are not controlled by compression garment alone. Surgical management, such as liposuction, lymphatico-venous anastomoses and vascularized lymph node transfer, can be considered in selected patients, although objective long-term results are limited.

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References

  1. DiSipio T, Rye S, Newman B, et al. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 2013;14:500–15.

    Article  PubMed  Google Scholar 

  2. Kwan ML, Darbinian J, Schmitz KH, et al. Risk factors for lymphedema in a prospective breast cancer survivorship study: the pathways study. Arch Surg. 2010;145:1055–63.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Norman SA, Localio AR, Potashnik SL, et al. Lymphedema in breast cancer survivors: incidence, degree, time course, treatment, and symptoms. J Clin Oncol. 2009;27:390–7.

    Article  PubMed  PubMed Central  Google Scholar 

  4. McLaughlin SA, Wright MJ, Morris KT, et al. Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements. J Clin Oncol. 2008;26:5213–9.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Paskett ED, Naughton MJ, McCoy TP, et al. The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiol Biomark Prev. 2007;16:775–82.

    Article  Google Scholar 

  6. Petrek JA, Senie RT, Peters M, et al. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001;92:1368–77.

    Article  CAS  PubMed  Google Scholar 

  7. Goldberg JI, Wiechmann LI, Riedel ER, et al. Morbidity of sentinel node biopsy in breast cancer: the relationship between the number of excised lymph nodes and lymphedema. Ann Surg Oncol. 2010;17:3278–86.

    Article  PubMed  Google Scholar 

  8. Shaitelman SF, Cromwell KD, Rasmussen JC, et al. Recent progress in the treatment and prevention of cancer-related lymphedema. CA Cancer J Clin. 2015;65:55–81.

    Article  PubMed  Google Scholar 

  9. Wilke LG, McCall LM, Posther KE, et al. Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 2006;13:491–500.

    Article  PubMed  Google Scholar 

  10. Alitalo K. The lymphatic vasculature in disease. Nat Med. 2011;17:1371–80.

    Article  CAS  PubMed  Google Scholar 

  11. Maclellan R. The lymphatic system. In: Greene A, Slavin S, Brorson H, editors. Lymphedema: presentation, diagnosis and treatment. Switzerland: Springer International Publishing; 2015. p. 3–7.

    Google Scholar 

  12. Zampell JC, Aschen S, Weitman ES, et al. Regulation of adipogenesis by lymphatic fluid stasis: part I. Adipogenesis, fibrosis, and inflammation. Plast Reconstr Surg. 2012;129:825–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Mortimer PS. The pathophysiology of lymphedema. Cancer. 1998;83:2798–802.

    Article  CAS  PubMed  Google Scholar 

  14. Hespe G, Nitti M, Mehrara B. Pathophysiology of lymphedema. In: Greene A, Slavin S, Brorson H, editors. Lymphedema: presentation, diagnosis and treatment. Switzerland: Springer International Publishing; 2015. p. 9–18.

    Google Scholar 

  15. Aschen S, Zampell JC, Elhadad S, et al. Regulation of adipogenesis by lymphatic fluid stasis: part II. Expression of adipose differentiation genes. Plast Reconstr Surg. 2012;129:838–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Brorson H, Ohlin K, Olsson G, et al. Adipose tissue dominates chronic arm lymphedema following breast cancer: an analysis using volume rendered CT images. Lymphat Res Biol. 2006;4:199–210.

    Article  PubMed  Google Scholar 

  17. Szuba A, Razavi M, Rockson SG. Diagnosis and treatment of concomitant venous obstruction in patients with secondary lymphedema. J Vasc Interv Radiol. 2002;13:799–803.

    Article  PubMed  Google Scholar 

  18. Coriddi M, Khansa I, Stephens J, et al. Analysis of factors contributing to severity of breast cancer-related lymphedema. Ann Plast Surg. 2015;74:22–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Lucci A, McCall LM, Beitsch PD, et al. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons oncology group trial Z0011. J Clin Oncol. 2007;25:3657–63.

    Article  PubMed  Google Scholar 

  20. Purushotham AD, Upponi S, Klevesath MB, et al. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol. 2005;23:4312–21.

    Article  PubMed  Google Scholar 

  21. Schrenk P, Rieger R, Shamiyeh A, et al. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer. 2000;88:608–14.

    Article  CAS  PubMed  Google Scholar 

  22. Kilbreath SL, Refshauge KM, Beith JM, et al. Risk factors for lymphoedema in women with breast cancer: a large prospective cohort. Breast. 2016;28:29–36.

    Article  CAS  PubMed  Google Scholar 

  23. Hayes SC, Janda M, Cornish B, et al. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol. 2008;26:3536–42.

    Article  PubMed  Google Scholar 

  24. Herd-Smith A, Russo A, Muraca MG, et al. Prognostic factors for lymphedema after primary treatment of breast carcinoma. Cancer. 2001;92:1783–7.

    Article  CAS  PubMed  Google Scholar 

  25. Helyer LK, Varnic M, Le LW, et al. Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients. Breast J. 2010;16:48–54.

    Article  PubMed  Google Scholar 

  26. Sener SF, Winchester DJ, Martz CH, et al. Lymphedema after sentinel lymphadenectomy for breast carcinoma. Cancer. 2001;92:748–52.

    Article  CAS  PubMed  Google Scholar 

  27. Amore M, Tapia L, Mercado D, et al. Lymphedema: a general outline of its anatomical base. J Reconstr Microsurg. 2016;32:2–9.

    CAS  PubMed  Google Scholar 

  28. Boccardo FM, Casabona F, Friedman D, et al. Surgical prevention of arm lymphedema after breast cancer treatment. Ann Surg Oncol. 2011;18:2500–5.

    Article  PubMed  Google Scholar 

  29. Leduc A, Caplan I, Leduc O. Lymphatic drainage of the upper limb. Eur J Lymphology Relat Probl. 1993;4:11–8.

    Google Scholar 

  30. Nesvold IL, Dahl AA, Lokkevik E, et al. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy. Acta Oncol. 2008;47:835–42.

    Article  PubMed  Google Scholar 

  31. Shah C, Wilkinson JB, Baschnagel A, et al. Factors associated with the development of breast cancer-related lymphedema after whole-breast irradiation. Int J Radiat Oncol Biol Phys. 2012;83:1095–100.

    Article  PubMed  Google Scholar 

  32. Coen JJ, Taghian AG, Kachnic LA, et al. Risk of lymphedema after regional nodal irradiation with breast conservation therapy. Int J Radiat Oncol Biol Phys. 2003;55:1209–15.

    Article  PubMed  Google Scholar 

  33. Hayes SB, Freedman GM, Li T, et al. Does axillary boost increase lymphedema compared with supraclavicular radiation alone after breast conservation? Int J Radiat Oncol Biol Phys. 2008;72:1449–55.

    Article  PubMed  Google Scholar 

  34. Avraham T, Yan A, Zampell JC, et al. Radiation therapy causes loss of dermal lymphatic vessels and interferes with lymphatic function by TGF-beta1-mediated tissue fibrosis. Am J Physiol Cell Physiol. 2010;299:C589–605.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Weitman ES, Aschen SZ, Farias-Eisner G, et al. Obesity impairs lymphatic fluid transport and dendritic cell migration to lymph nodes. PLoS One. 2013;8:e70703.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Savetsky IL, Torrisi JS, Cuzzone DA, et al. Obesity increases inflammation and impairs lymphatic function in a mouse model of lymphedema. Am J Physiol Heart Circ Physiol. 2014;307:H165–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Mehrara BJ, Greene AK. Lymphedema and obesity: is there a link? Plast Reconstr Surg. 2014;134:154e–60e.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Miaskowski C, Dodd M, Paul SM, et al. Lymphatic and angiogenic candidate genes predict the development of secondary lymphedema following breast cancer surgery. PLoS One. 2013;8:e60164.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Newman B, Lose F, Kedda MA, et al. Possible genetic predisposition to lymphedema after breast cancer. Lymphat Res Biol. 2012;10:2–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Finegold DN, Baty CJ, Knickelbein KZ, et al. Connexin 47 mutations increase risk for secondary lymphedema following breast cancer treatment. Clin Cancer Res. 2012;18:2382–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Vignes S, Arrault M, Dupuy A. Factors associated with increased breast cancer-related lymphedema volume. Acta Oncol. 2007;46:1138–42.

    Article  PubMed  Google Scholar 

  42. Kim M, Shin KH, Jung SY, et al. Identification of prognostic risk factors for transient and persistent lymphedema after multimodal treatment for breast cancer. Cancer Res Treat. 2016;48(4):1330–7.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Kilbreath SL, Lee MJ, Refshauge KM, et al. Transient swelling versus lymphoedema in the first year following surgery for breast cancer. Support Care Cancer. 2013;21:2207–15.

    Article  PubMed  Google Scholar 

  44. Taghian NR, Miller CL, Jammallo LS, et al. Lymphedema following breast cancer treatment and impact on quality of life: a review. Crit Rev Oncol Hematol. 2014;92:227–34.

    Article  PubMed  Google Scholar 

  45. Ahmed RL, Prizment A, Lazovich D, et al. Lymphedema and quality of life in breast cancer survivors: the Iowa Women’s health study. J Clin Oncol. 2008;26:5689–96.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Alcorso J, Sherman KA. Factors associated with psychological distress in women with breast cancer-related lymphoedema. Psychooncology. 2016;25:865–72.

    Article  PubMed  Google Scholar 

  47. International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 consensus document of the International Society of Lymphology. Lymphology. 2013;46:1–11.

    Google Scholar 

  48. Godal R, Swedborg I. A correction for the natural asymmetry of the arms in the determination of the volume of oedema. Scand J Rehabil Med. 1982;14:193–5.

    CAS  PubMed  Google Scholar 

  49. Armer JM, Stewart BR. A comparison of four diagnostic criteria for lymphedema in a post-breast cancer population. Lymphat Res Biol. 2005;3:208–17.

    Article  PubMed  Google Scholar 

  50. Tsai RJ, Dennis LK, Lynch CF, et al. The risk of developing arm lymphedema among breast cancer survivors: a meta-analysis of treatment factors. Ann Surg Oncol. 2009;16:1959–72.

    Article  PubMed  Google Scholar 

  51. Adriaenssens N, Buyl R, Lievens P, et al. Comparative study between mobile infrared optoelectronic volumetry with a Perometer and two commonly used methods for the evaluation of arm volume in patients with breast cancer related lymphedema of the arm. Lymphology. 2013;46:132–43.

    CAS  PubMed  Google Scholar 

  52. Deltombe T, Jamart J, Recloux S, et al. Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema. Lymphology. 2007;40:26–34.

    CAS  PubMed  Google Scholar 

  53. Cornish BH, Chapman M, Hirst C, et al. Early diagnosis of lymphedema using multiple frequency bioimpedance. Lymphology. 2001;34:2–11.

    CAS  PubMed  Google Scholar 

  54. Warren AG, Janz BA, Slavin SA, et al. The use of bioimpedance analysis to evaluate lymphedema. Ann Plast Surg. 2007;58:541–3.

    Article  CAS  PubMed  Google Scholar 

  55. Mayrovitz HN, Weingrad DN, Davey S. Local tissue water in at-risk and contralateral forearms of women with and without breast cancer treatment-related lymphedema. Lymphat Res Biol. 2009;7:153–8.

    Article  PubMed  Google Scholar 

  56. Lahtinen T, Seppala J, Viren T, et al. Experimental and analytical comparisons of tissue dielectric constant (TDC) and bioimpedance spectroscopy (BIS) in assessment of early arm lymphedema in breast cancer patients after axillary surgery and radiotherapy. Lymphat Res Biol. 2015;13:176–85.

    Article  PubMed  Google Scholar 

  57. Warren AG, Brorson H, Borud LJ, et al. Lymphedema: a comprehensive review. Ann Plast Surg. 2007;59:464–72.

    Article  CAS  PubMed  Google Scholar 

  58. Sharma R, Wendt JA, Rasmussen JC, et al. New horizons for imaging lymphatic function. Ann N Y Acad Sci. 2008;1131:13–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Kleinhans E, Baumeister RG, Hahn D, et al. Evaluation of transport kinetics in lymphoscintigraphy: follow-up study in patients with transplanted lymphatic vessels. Eur J Nucl Med. 1985;10:349–52.

    Article  CAS  PubMed  Google Scholar 

  60. Liu N, Zhang Y. Magnetic resonance lymphangiography for the study of lymphatic system in lymphedema. J Reconstr Microsurg. 2016;32:66–71.

    PubMed  Google Scholar 

  61. Borri M, Schmidt MA, Gordon KD, et al. Quantitative contrast-enhanced magnetic resonance lymphangiography of the upper limbs in breast cancer related lymphedema: an exploratory study. Lymphat Res Biol. 2015;13:100–6.

    Article  PubMed  PubMed Central  Google Scholar 

  62. White RD, Weir-McCall JR, Budak MJ, et al. Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema. Clin Radiol. 2014;69:e435–44.

    Article  CAS  PubMed  Google Scholar 

  63. Mihara M, Hara H, Araki J, et al. Indocyanine green (ICG) lymphography is superior to lymphoscintigraphy for diagnostic imaging of early lymphedema of the upper limbs. PLoS One. 2012;7:e38182.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Yamamoto T, Narushima M, Yoshimatsu H, et al. Dynamic indocyanine green (ICG) lymphography for breast cancer-related arm lymphedema. Ann Plast Surg. 2014;73:706–9.

    Article  CAS  PubMed  Google Scholar 

  65. Yamamoto T, Matsuda N, Doi K, et al. The earliest finding of indocyanine green lymphography in asymptomatic limbs of lower extremity lymphedema patients secondary to cancer treatment: the modified dermal backflow stage and concept of subclinical lymphedema. Plast Reconstr Surg. 2011;128:314e–21e.

    Article  CAS  PubMed  Google Scholar 

  66. Stout Gergich NL, Pfalzer LA, McGarvey C, et al. Preoperative assessment enables the early diagnosis and successful treatment of lymphedema. Cancer. 2008;112:2809–19.

    Article  PubMed  Google Scholar 

  67. Shaw C, Mortimer P, Judd PA. Randomized controlled trial comparing a low-fat diet with a weight-reduction diet in breast cancer-related lymphedema. Cancer. 2007;109:1949–56.

    Article  PubMed  Google Scholar 

  68. Singh B, Disipio T, Peake J, et al. Systematic review and meta-analysis of the effects of exercise for those with cancer-related lymphedema. Arch Phys Med Rehabil. 2016;97:302–315.e13.

    Article  PubMed  Google Scholar 

  69. Ahmed RL, Thomas W, Yee D, et al. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol. 2006;24:2765–72.

    Article  PubMed  Google Scholar 

  70. McNeely ML, Peddle CJ, Yurick JL, et al. Conservative and dietary interventions for cancer-related lymphedema: a systematic review and meta-analysis. Cancer. 2011;117:1136–48.

    Article  PubMed  Google Scholar 

  71. Kwan ML, Cohn JC, Armer JM, et al. Exercise in patients with lymphedema: a systematic review of the contemporary literature. J Cancer Surviv. 2011;5:320–36.

    Article  PubMed  Google Scholar 

  72. Dayes IS, Whelan TJ, Julian JA, et al. Randomized trial of decongestive lymphatic therapy for the treatment of lymphedema in women with breast cancer. J Clin Oncol. 2013;31:3758–63.

    Article  CAS  PubMed  Google Scholar 

  73. Lasinski BB, McKillip Thrift K, Squire D, et al. A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011. PM R. 2012;4:580–601.

    Article  PubMed  Google Scholar 

  74. Ezzo J, Manheimer E, McNeely ML, et al. Manual lymphatic drainage for lymphedema following breast cancer treatment. Cochrane Database Syst Rev. 2015;5:CD003475. doi:10.1002/14651858.CD003475.

    Google Scholar 

  75. Huang TW, Tseng SH, Lin CC, et al. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol. 2013;11:15. doi:10.1186/1477-7819-11-15.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Vignes S. Complex decongestive therapy. In: Greene A, Slavin S, Brorson H, editors. Lymphedema: presentation, diagnosis, and treatment. Switzerland: Springer International Publishing; 2015. p. 227–35.

    Google Scholar 

  77. Brorson H. Liposuction in lymphedema treatment. J Reconstr Microsurg. 2016;32:56–65.

    PubMed  Google Scholar 

  78. Brorson H. Complete reduction of arm lymphedema following breast cancer – a prospective twenty-one years’ study. Plast Reconstr Surg. 2015;136:134–5.

    Article  PubMed  Google Scholar 

  79. Brorson H, Svensson H, Norrgren K, et al. Liposuction reduces arm lymphedema without significantly altering the already impaired lymph transport. Lymphology. 1998;31:156–72.

    CAS  PubMed  Google Scholar 

  80. Frick A, Hoffmann JN, Baumeister RG, et al. Liposuction technique and lymphatic lesions in lower legs: anatomic study to reduce risks. Plast Reconstr Surg. 1999;103:1868–73. discussion 1874-5

    Article  CAS  PubMed  Google Scholar 

  81. Chang DW, Suami H, Skoracki R. A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema. Plast Reconstr Surg. 2013;132:1305–14.

    Article  CAS  PubMed  Google Scholar 

  82. Campisi C, Bellini C, Campisi C, et al. Microsurgery for lymphedema: clinical research and long-term results. Microsurgery. 2010;30:256–60.

    PubMed  Google Scholar 

  83. Basta MN, Gao LL, Wu LC. Operative treatment of peripheral lymphedema: a systematic meta-analysis of the efficacy and safety of lymphovenous microsurgery and tissue transplantation. Plast Reconstr Surg. 2014;133:905–13.

    Article  CAS  PubMed  Google Scholar 

  84. Mihara M, Hara H, Furniss D, et al. Lymphaticovenular anastomosis to prevent cellulitis associated with lymphoedema. Br J Surg. 2014;101:1391–6.

    Article  CAS  PubMed  Google Scholar 

  85. Baumeister RG, Mayo W, Notohamiprodjo M, et al. Microsurgical lymphatic vessel transplantation. J Reconstr Microsurg. 2016;32:34–41.

    PubMed  Google Scholar 

  86. Becker C, Assouad J, Riquet M, et al. Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation. Ann Surg. 2006;243:313–5.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Becker C, Vasile JV, Levine JL, et al. Microlymphatic surgery for the treatment of iatrogenic lymphedema. Clin Plast Surg. 2012;39:385–98.

    Article  PubMed  Google Scholar 

  88. Yan A, Avraham T, Zampell JC, et al. Mechanisms of lymphatic regeneration after tissue transfer. PLoS One. 2011;6:e17201.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Aschen SZ, Farias-Eisner G, Cuzzone DA, et al. Lymph node transplantation results in spontaneous lymphatic reconnection and restoration of lymphatic flow. Plast Reconstr Surg. 2014;133:301–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Cheng MH, Huang JJ, Wu CW, et al. The mechanism of vascularized lymph node transfer for lymphedema: natural lymphaticovenous drainage. Plast Reconstr Surg. 2014;133:192e–8e.

    Article  CAS  PubMed  Google Scholar 

  91. Cheng MH, Chen SC, Henry SL, et al. Vascularized groin lymph node flap transfer for postmastectomy upper limb lymphedema: flap anatomy, recipient sites, and outcomes. Plast Reconstr Surg. 2013;131:1286–98.

    Article  CAS  PubMed  Google Scholar 

  92. Viitanen TP, Visuri MT, Hartiala P, et al. Lymphatic vessel function and lymphatic growth factor secretion after microvascular lymph node transfer in lymphedema patients. Plast Reconstr Surg Glob Open. 2013;1:1–9.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Becker C, Pham DN, Assouad J, et al. Postmastectomy neuropathic pain: results of microsurgical lymph nodes transplantation. Breast. 2008;17:472–6.

    Article  PubMed  Google Scholar 

  94. Tourani SS, Taylor GI, Ashton MW. Vascularized lymph node transfer: a review of the current evidence. Plast Reconstr Surg. 2016;137:985–93.

    Article  CAS  PubMed  Google Scholar 

  95. Barreiro GC, Baptista RR, Kasai KE, et al. Lymph fasciocutaneous lateral thoracic artery flap: anatomical study and clinical use. J Reconstr Microsurg. 2014;30:389–96.

    Article  PubMed  Google Scholar 

  96. Althubaiti GA, Crosby MA, Chang DW. Vascularized supraclavicular lymph node transfer for lower extremity lymphedema treatment. Plast Reconstr Surg. 2013;131:133e–5e.

    Article  CAS  PubMed  Google Scholar 

  97. Sapountzis S, Singhal D, Rashid A, et al. Lymph node flap based on the right transverse cervical artery as a donor site for lymph node transfer. Ann Plast Surg. 2014;73:398–401.

    Article  CAS  PubMed  Google Scholar 

  98. Cheng MH, Huang JJ, Nguyen DH, et al. A novel approach to the treatment of lower extremity lymphedema by transferring a vascularized submental lymph node flap to the ankle. Gynecol Oncol. 2012;126:93–8.

    Article  PubMed  Google Scholar 

  99. Viitanen TP, Maki MT, Seppanen MP, et al. Donor-site lymphatic function after microvascular lymph node transfer. Plast Reconstr Surg. 2012;130:1246–53.

    Article  CAS  PubMed  Google Scholar 

  100. Vignes S, Blanchard M, Yannoutsos A, et al. Complications of autologous lymph-node transplantation for limb lymphoedema. Eur J Vasc Endovasc Surg. 2013;45:516–20.

    Article  CAS  PubMed  Google Scholar 

  101. Dayan JH, Dayan E, Smith ML. Reverse lymphatic mapping: a new technique for maximizing safety in vascularized lymph node transfer. Plast Reconstr Surg. 2015;135:277–85.

    Article  CAS  PubMed  Google Scholar 

  102. Patel KM, Lin CY, Cheng MH. A prospective evaluation of lymphedema-specific quality-of-life outcomes following vascularized lymph node transfer. Ann Surg Oncol. 2015;22:2424–30.

    Article  PubMed  Google Scholar 

  103. De Brucker B, Zeltzer A, Seidenstuecker K, et al. Breast cancer-related lymphedema: quality of life after lymph node transfer. Plast Reconstr Surg. 2016;137:1673–80.

    Article  PubMed  CAS  Google Scholar 

  104. Saaristo AM, Niemi TS, Viitanen TP, et al. Microvascular breast reconstruction and lymph node transfer for postmastectomy lymphedema patients. Ann Surg. 2012;255:468–73.

    Article  PubMed  Google Scholar 

  105. Nguyen AT, Chang EI, Suami H, et al. An algorithmic approach to simultaneous vascularized lymph node transfer with microvascular breast reconstruction. Ann Surg Oncol. 2015;22:2919–24.

    Article  PubMed  Google Scholar 

  106. Masia J, Pons G, Nardulli ML. Combined surgical treatment in breast cancer-related lymphedema. J Reconstr Microsurg. 2016;32:16–27.

    Article  PubMed  Google Scholar 

  107. Suominen S, Kolehmainen M. Transverse myocutaneous gracilis with vascularized lymph node transfer. In: Neligan P, Masia M, Piller N, editors. Lymphedema: complete medical and surgical management. Boca Raton, Fl: CMC Press, Taylor and Francis; 2015. p. 519–25.

    Google Scholar 

  108. Torres Lacomba M, Yuste Sanchez MJ, Zapico Goni A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010;340:b5396.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Ferguson CM, Swaroop MN, Horick N, et al. Impact of ipsilateral blood draws, injections, blood pressure measurements, and air travel on the risk of lymphedema for patients treated for breast cancer. J Clin Oncol. 2016;34:691–8.

    Article  PubMed  Google Scholar 

  110. Soran A, Ozmen T, McGuire KP, et al. The importance of detection of subclinical lymphedema for the prevention of breast cancer-related clinical lymphedema after axillary lymph node dissection; a prospective observational study. Lymphat Res Biol. 2014;12:289–94.

    Article  PubMed  Google Scholar 

  111. Masia J, Pons G, Rodriguez-Bauza E. Barcelona lymphedema algorithm for surgical treatment in breast cancer-related lymphedema. J Reconstr Microsurg. 2016;32:329–35.

    Article  PubMed  Google Scholar 

  112. Lahteenvuo M, Honkonen K, Tervala T, et al. Growth factor therapy and autologous lymph node transfer in lymphedema. Circulation. 2011;123:613–20.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Plastic Surgery, Helsinki University Hospital, 00029 HUS, Helsinki, Finland

    Heli Kavola MD, PhD & Sinikka Suominen MD, PhD

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  1. Heli Kavola MD, PhD
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  2. Sinikka Suominen MD, PhD
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Correspondence to Heli Kavola MD, PhD .

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  1. The Medical School Department of Oncology, University of Sheffield, Sheffield, United Kingdom

    Lynda Wyld

  2. Athens University Medical School, Athens, Greece

    Christos Markopoulos

  3. Helsinki University Hospital, Helsinki, Finland

    Marjut Leidenius

  4. Department of Oncology & Radiotherapy, Gdańsk Medical University Department of Oncology & Radiotherapy, Gdańsk, Poland

    Elżbieta Senkus-Konefka

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Kavola, H., Suominen, S. (2018). Breast Cancer-Related Lymphedema. In: Wyld, L., Markopoulos, C., Leidenius, M., Senkus-Konefka, E. (eds) Breast Cancer Management for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-56673-3_62

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