It is estimated that more than 2.5 million American women have been diagnosed with breast cancer. Many breast cancer cases require a combination of surgery, radiation, and/or chemotherapy. Each of these life-saving treatments has the potential to damage or eliminate lymph nodes, creating a susceptibility to upper extremity lymphedema. Even with the best standard of care that has been available, women who develop lymphedema after breast cancer treatment may suffer a profound impairment of quality of life. To better manage this condition, doctors have developed meticulous surgical techniques to improve lymphatic drainage. Autologous lymph node transfer is one of them.
The lymphatic system is integral to good health and physical comfort. This system is responsible for collecting waste and bacteria from the body and flushing it. When one or more lymph nodes are removed during breast cancer surgery or are affected by radiation or chemotherapy, lymphatic fluid does not drain as well as it must. The undrained fluid builds up, usually in the arm, and causes swelling. The risk of upper extremity lymphedema exists for every woman who undergoes breast surgery, radiation, or lymph node surgery.
Data from several studies suggest that 15 to 54% of breast cancer survivors develop upper extremity lymphedema within three years of treatment. After that time, there is a 1% chance of developing the condition. This risk remains for at least 20 years. However, if treatment is administered at the first sign of lymphedema, the condition is usually quite responsive. Early detection and treatment can prevent unnecessary discomfort and emotional distress.
The Old and The New Combine for Optimal Improvement
Historically, complete decongestive therapy has been the standard of care for upper extremity lymphedema. This treatment reduces swelling by manually draining fluid from the affected arm. Complete decongestive therapy has typically been a lifelong management strategy. It includes compression garments, massage performed by a licensed therapist, and range-of-motion exercises. It cannot prevent instances of swelling but it may reduce the intensity of symptoms and resolve them more quickly.
A newer treatment for upper extremity lymphedema is autologous lymph node transfer. This microsurgical technique harvests healthy lymph nodes from one area of the body to replace those that have been removed or damaged by breast cancer treatment. The procedure does not transfer only the lymph nodes but also their intact blood vessels. These blood vessels are microsurgically reconnected at the transfer site, where they become vessels for lymphatic fluid to drain properly. Evidence suggests that new pathways for lymphatic drainage may also grow after the transfer procedure.
Autologous lymph node transfer may not eliminate the need for complete decongestive therapy. However, this need is often reduced. We are pleased to offer this and other treatment options for upper extremity lymphedema in our office at Keck Medicine of USC. Call 323.442.0416 to schedule your consultation.