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Clinical and Psychosocial Outcomes of Vascularized Lymph Node Transfer for the Treatment of Upper Extremity Lymphedema After Breast Cancer Therapy

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

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Background

Secondary lymphedema following breast cancer therapy remains a major problem. Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema that has shown promising results, but limited studies in the United States have investigated outcomes for single-stage VLNT to the axilla. The goal of this prospective, ongoing study was to investigate the clinical, psychosocial, and functional outcomes of patients who underwent VLNT for the treatment of upper extremity lymphedema after breast cancer therapy.

Study Design

VLNT to the axilla were performed on patients with upper extremity lymphedema after breast cancer therapy. Patients were evaluated preoperatively and postoperatively at 1-, 3-, 6-, 9-, and 12-month intervals by circumferential measurements, pain/heaviness scales, and the LYMQOL questionnaire.

Results

Fifty patients met the study criteria. Preliminary results showed a decrease in arm volumes by 34.57 % at 1 month, 52.03 % at 3 months, 42.34 % at 6 months, 65.23 % at 9 months, and 58.68 % at 12 months. Pain and heaviness consistently decreased over time to 0.38 and 1.67 respectively at 12 months. Overall quality of life scores steadily improved from 5.72 preoperatively to 7.79 at 12 months. There was a significant decrease in the number of infections of the affected arm postoperatively and a decreased need for physiotherapy. Complications occurred in 17 patients and consisted mainly of minor wound complications.

Conclusions

VLNT continues to demonstrate its value as a safe and effective treatment option for lymphedema after breast cancer therapy. Significant reductions in volume are accompanied by a decrease in symptoms and improvement in quality of life.

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Authors and Affiliations

  1. Orlando Health, Orlando, FL, USA

    Andrew Gratzon MD, Kristine Secrest OTR/L, CLT-LANA, Kenneth Lee MD, FACS, Jeffrey Feiner MD & Richard D. Klein MD, MPH, FACS

  2. University of Central Florida College of Medicine, Orlando, FL, USA

    Jerette Schultz BS

  3. Center for Reconstructive Surgery, UF Health Cancer Center at Orlando Health, Orlando, FL, 32806, USA

    Richard D. Klein MD, MPH, FACS

Authors
  1. Andrew Gratzon MD
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  2. Jerette Schultz BS
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  3. Kristine Secrest OTR/L, CLT-LANA
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  4. Kenneth Lee MD, FACS
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  5. Jeffrey Feiner MD
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  6. Richard D. Klein MD, MPH, FACS
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Corresponding author

Correspondence to Richard D. Klein MD, MPH, FACS.

Additional information

This research has received first place awards for the 2015 National ACS Commission on Cancer Research Paper Competition for Physicians-in-Training, and 2015 Florida ACS Copeland Research Paper Competition.

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Gratzon, A., Schultz, J., Secrest, K. et al. Clinical and Psychosocial Outcomes of Vascularized Lymph Node Transfer for the Treatment of Upper Extremity Lymphedema After Breast Cancer Therapy. Ann Surg Oncol 24, 1475–1481 (2017). https://doi.org/10.1245/s10434-016-5614-4

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  • DOI: https://doi.org/10.1245/s10434-016-5614-4

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