What Causes Lymphedema?
Lymphedema is a condition that can occur after breast cancer surgery. The condition can develop as a result of an alteration in the pathways that drain the fluids involved in the immune system. This disruption of the flow of lymph can happen when lymph nodes are removed from the armpit for biopsy or by radiation scarring that may potentially block or damage lymph. Lymphedema can cause buildup of excess fluid in the body which leads to swelling in areas like the arms, hands, legs, neck, shoulders and other regions of the body.
Surgical Options for Managing Lymphedema
Up until recently, lymphedema has primarily been managed using a combination of manual lymphatic drainage (massage), therapeutic exercise, skin care and compression garments. However, a relatively new microsurgical procedure called Vascularized Lymph Node Transfer is proving to be very successful in the treatment of lymphedema.
This surgical technique involves harvesting one or two lymph nodes from the groin area, along with their supporting artery and vein. (The groin area is considered to be a low-risk lymph node basin.) These lymph nodes are then microsurgically transplanted to the area under the arm. Lymph node transfer can be performed as a stand-alone procedure or in conjunction with a Deep Inferior Epigastric Perforator (DIEP) flap. In patients requiring breast reconstruction, when the lymph nodes are removed, they are taken attached to the DIEP flap. The flap is then transferred to the chest wall where the DIEP flap is placed into the breast pocket, and the attached lymph node transfer flap is positioned into the axilla.
With the aid of a surgical microscope, blood flow is then re-established by connecting the blood vessels of the lymph node flap to the blood vessels found in the recipient site. After the procedure, patients resume manual lymphatic massage and wear compression garments. Usually within a week, the newly placed lymph nodes begin to take effect and soon after, most patients begin seeing an improvement in soft-tissue swelling. Patients typically notice a reduction in discomfort and heaviness in the affected area, and may continue to see improvement for up to 6 months.
Lymph Node Transfer Procedures
For more information on lymphedema and treatment methods, please visit our lymphedema treatment page. If you are interested in undergoing a lymph node transfer in Houston with Dr. Aldona J. Spiegel, please contact the Center for Breast Restoration at (713) 441-6102.