BACKGROUND: Lymphedema is a significant health burden for patients with breast cancer. Previous studies have identified that the rate of lymphedema with axillary lymph node dissection (ALND) and adjuvant radiation is around 34%. By collaborating with the breast surgeons and offering immediate lymphatic reconstruction (ILR) we can reduce the rate of lymphedema. METHODS: Retrospective review of all patients having ALND and ILR with lympho-venous bypass (LVB) at Moffitt Cancer Center. RESULTS: Between March 2023 and February 2026 151 cases of ALND and LVB were performed. Seventy-two cases with follow up more than 1 year were included in the analysis. LV bypass was able to be performed in 96% of patients. In 4% of cases the case had to be abandoned because there was no appropriate vein or lymphatics for the anastomosis. A coupler lympho-venous anastomosis was performed in 28% of cases and a suture invagination technique in 72% of cases. 22% patients had previous reconstruction, 22% of patients had immediate tissue expander reconstruction, 26% flap reconstruction and 5.6% had lumpectomy. 24% of patients were not eligible or chose not to have immediate reconstruction. Mean follow-up was 18.5 months with a range from 12 to 32 months. 9.7% of patients developed lymphedema. CONCLUSION: ILR at the time of ALND reduces the rate of lymphedema. Our study is ongoing and more patients with longer follow up are required to accurately determine our lymphedema rate and the impact of immediate breast reconstruction to the development of lymphedema.
Evgeniou et al. (Mon,) studied this question.
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