I am Dr. Tom Davenport. I’m a board certified plastic surgeon at the Long Island Plastic Surgical Group. And one of my specialties is breast reconstruction.
Lymphedema is an obstruction of the lymphatic system, and this can happen with breast cancer, and specifically after a mastectomy of radiation treatment or with any disruption of the lymphatics with an axillary dissection. Lymphedema is caused by any disruption of the lymphatic system, and this is a disruption of both the lymph nodes or the lymphatic vessels.
The lymphatic system is actually part of the vascular system in that it helps to bring fluid back from the periphery of the body. When this system is obstructed, or this system is affected by radiation therapy, this can cause lymphedema, which is a swelling of the extremity. And this could be a very mild swelling, such that it’s not even visible but the patient can even feel it when they’re moving, when they’re clenching their fist, when they’re walking, when they’re trying to wear shoes. So this swelling can cause a disruption of the activities of daily living.
The cause of lymphedema is part of their cancer treatment. So very often it’s an axillary dissection or radiation treatment that is part of the treatment. So very often it’s difficult to affect the progression or the development of lymphedema. Patients early on can undergo special lymphatic treatment after they’ve had their lymph nodes removed or after they’ve had their radiation therapy. Patients are able to wear compress garments or even certain physical therapy treatments that help the patient’s lymphatics can improve lymphedema or prevent it from getting worse.
There are recent advancements in the surgery for lymphedema, and these treatments include reestablishing connections of the lymphatic system. And this would be lymph node transfer, which is a surgical transfer of lymph nodes. Being able to bypass the obstructed lymph system, which is a lymphovenous bypass. There’s also data to show that possibly doing this repair at the time of the mastectomy, where doing a lymphovenous bypass at the time of an axillary dissection can improve and decrease the possibility of lymphedema.