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Surgical Approaches to the Prevention and Management of Breast Cancer–Related Lymphedema

  • Lymphedema Incidence, Prevention and Treatment (J Armer, Section Editor)
  • Published:
Current Breast Cancer Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Upper extremity lymphedema is a much-feared complication of breast cancer treatment leading to significant impairments in patients’ quality of life. The mainstay of treatment for this debilitating chronic disease has been non-surgical modalities, namely complete decongestive therapies. Surgical treatment of lymphedema has emerged as an option for patients who have exhausted these conservative measures and consists of both physiologic procedures (vascularized lymph node transplant and lymphovenous bypass) which aim to reduce the burden of lymphatic fluid and reductive procedures to remove excess soft tissue.

Recent Findings

Opinions vary among surgeons regarding the appropriate surgical indications in patients with different stages of lymphedema for each type of surgery, as well as the optimal donor site for lymph node transplant, and recent studies are beginning to address these questions. Additionally, there is growing data regarding the benefits of preventative lymphatic surgery at the time of axillary lymph node dissection, as well as the cost effectiveness of this approach.

Summary

Surgical approaches for the prevention and treatment of breast cancer–related lymphedema are gaining popularity as a means of improving patients’ quality of life. There is an expanding body of literature demonstrating the effectiveness of these surgical procedures in terms of reduction in arm circumference, decreased cellulitis incidence, and overall quality of life, as well as emerging evidence of their cost effectiveness.

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  1. Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave, Rm J641, MC 6035, Chicago, IL, 60637, USA

    Kristine C. Rustad & David W. Chang

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Correspondence to David W. Chang.

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This article is part of the Topical Collection on Lymphedema Incidence, Prevention and Treatment

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Rustad, K.C., Chang, D.W. Surgical Approaches to the Prevention and Management of Breast Cancer–Related Lymphedema. Curr Breast Cancer Rep 12, 185–192 (2020). https://doi.org/10.1007/s12609-020-00372-1

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