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Surgery for Lymphedema Prevention and Treatment

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Abstract

Purpose of Review

This review explores the evidence surrounding the efficacy of preventing and treating lymphedema through surgical means.

Recent Findings

Sentinel Lymph Node Biopsy (SLNB) has significantly reduced the need for axillary lymph node dissection (ALND), decreasing lymphedema rates. Axillary Reverse Mapping (ARM) techniques offer the opportunity to identify and preserve lymphatics during surgery. Immediate lymphatic reconstruction through lymphatic or lymphatic venous anastomosis and free lymph node transfer attempt to maintain continued post-operative lymphatic flow, further mitigating BCRL risks and optimizing patient outcomes.

Summary

A growing body of data is evaluating surgical techniques for lymphedema prevention and treatment. Improvements in patients’ quality of life have been reported with these techniques. Further research should focus on randomized controlled trials and prospective studies to investigate patient indications, technique selection, long-term durability, and personalized patient strategies.

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Acknowledgements

This study was partly supported by the Mayo Clinic Clinical Research Operations Group and Mayo Clinic Center for Regenerative Medicine.

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Authors and Affiliations

  1. Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA

    Karla C. Maita, Francisco R. Avila, Ricardo A. Torres-Guzman, John P. Garcia, Sahar Borna, Olivia A. Ho & Antonio J. Forte

  2. Department of Administration, Mayo Clinic, Jacksonville, FL, USA

    Sally A. Brown

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Contributions

Each author contributed significantly to the development and completion of this review. KCM and AJF were responsible for the conception and design of the study, including the identification of relevant literature, formulation of the research question, and overall structure of the manuscript. KCM, FRA and RAT, conducted an extensive literature search, critically analyzed the selected articles, and synthesized the information to support the main arguments and themes of the review. JPG and SB assisted in data extraction and analysis, contributing to the synthesis of the narrative review. OAH and AJF provided valuable input in the interpretation of findings, ensuring the accuracy and relevance of the content presented. SAB played a pivotal role in the revision process, ensuring clarity, coherence, and consistency in the manuscript. All authors contributed to the final draft, offering intellectual input and critical feedback, and approved the submission of this work for publication.

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Correspondence to Antonio J. Forte.

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Maita, K.C., Avila, F.R., Torres-Guzman, R.A. et al. Surgery for Lymphedema Prevention and Treatment. Curr Breast Cancer Rep (2024). https://doi.org/10.1007/s12609-024-00540-7

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