The Managing of Lymphatic Surgery Risks in Breast Cancer Patients

Introduction. Surgical staging is an essential component of breast cancer treatment. Sentinel lymph node biopsy (SLNB) can be used to exclude or confirm metastatic involvement of lymphatic collectors. Despite minimal invasiveness of this procedure, surgeons still encounter adverse events in the postoperative period. The aim of this study was to explore ways of reducing the risk of postoperative complications after minimally invasive interventions on the lymphatic system. Materials and methods . We analyzed the medical records of 114 patients who underwent SLNB. The incidence of post‑operative complications was assessed in patient groups stratified by the number of excised lymph nodes. Based on prior experience in managing lymphorrhea, a subgroup of 28 patients was formed, in whom SLNB was performed with optical magnification, a double coagulation technique, and gentle principles of electrosurgery. Results and discussion . Reducing the number of excised nodes decreased the likelihood of complications, including seroma formation. Dividing patients into subgroups according to the number of removed lymph nodes revealed cases of metastatic spread to more collectors than the method could resolve. Taking this into account, the issue of abandoning lymph node dissection in the presence of sentinel node metastasis necessitates excision of at least two lymph nodes, with three excised nodes being considered optimal. Surgical interventions performed in accordance with these principles and using the described techniques were associated with lower risks of complications. Conclusion . The development of new technical solutions in surgical practice is very promising in improving patients’ quality of life. However, de-escalation of surgical management must be consistent and safe; otherwise, all the advantages of a well-performed operation are negated by excessive oncological risk.