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Lymphedema Microsurgical Preventive Healing Approach: A New Technique for Primary Prevention of Arm Lymphedema After Mastectomy

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The purpose of this manuscript is to assess the efficacy of direct lymphaticvenous microsurgery in the prevention of lymphedema following axillary dissection for breast cancer.

Methods

Nineteen patients with operable breast cancer requiring an axillary dissection underwent surgery, carrying out LVA between the blue lymphatics and an axillary vein branch simultaneously. The follow-up after 6 and 12 months from the operation included circumferential measurements in all cases and lymphangioscintigraphy only in 18 patients out of 19 cases.

Results

Blue nodes in relation to lymphatic arm drainage were identified in 18/19 patients. All blue nodes were resected and 2-4 main afferent lymphatics from the arm could be prepared and used for anastomoses. Lymphatic-venous anastomoses allowed to prevent lymphedema in all cases. Lymphangioscintigraphy demonstrated the patency of microvascular anastomoses.

Conclusions

Disruption of the blue nodes and closure of arm lymphatics can explain the significantly high risk of lymphedema after axillary dissection. LVA proved to be a safe procedure for patients in order to prevent arm lymphedema.

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Authors and Affiliations

  1. Department of Surgery, Unit of Lymphatic Surgery, S. Martino Hospital, University of Genoa, 16132, Genoa, Italy

    Francesco Boccardo MD & Corradino Campisi MD

  2. Department of Obstetrics and Gynecology, S. Martino Hospital, University of Genoa, Genoa, 16132, Italy

    Federico Casabona MD, Stefano Bogliolo MD & Simone Ferrero MD

  3. Department of Surgery, Unit of Oncologic Surgery, S. Martino Hospital, University of Genoa, 16132, Genoa, Italy

    Franco De Cian MD

  4. Department of Surgery, Breast Unit, S. Martino Hospital, University of Genoa, Genoa, 16132, Italy

    Daniele Friedman MD & Federica Murelli MD

  5. Department of Nuclear Medicine, S. Martino Hospital, University of Genoa, 16132, Genoa, Italy

    Giuseppe Villa MD

Authors
  1. Francesco Boccardo MD
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  2. Federico Casabona MD
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  3. Franco De Cian MD
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  4. Daniele Friedman MD
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  5. Giuseppe Villa MD
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  6. Stefano Bogliolo MD
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  7. Simone Ferrero MD
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  8. Federica Murelli MD
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  9. Corradino Campisi MD
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Corresponding author

Correspondence to Francesco Boccardo MD.

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Boccardo, F., Casabona, F., De Cian, F. et al. Lymphedema Microsurgical Preventive Healing Approach: A New Technique for Primary Prevention of Arm Lymphedema After Mastectomy. Ann Surg Oncol 16, 703–708 (2009). https://doi.org/10.1245/s10434-008-0270-y

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  • DOI: https://doi.org/10.1245/s10434-008-0270-y

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