D. Singhal1, M. Hahamoff2, N. Gupta2, D. Munoz2, C. Shaw2, L. Spiguel2, D. Singhal1 1BIDMC,Plastic & Reconstructive Surgery/ Surgery,Boston, MA, USA 2University Of Florida School Of Medicine,Plastic & Reconsruction/ Surgery,Gainesville, FL, USA
Introduction: Lymphedema is a progressive disease with no known cure. Lymphatic procedures for chronic lymphedema have not been able to deliver consistent results. More efforts have been put into early prevention. The Lymphedema Microsurgical Preventative Healing Approach (LYMPHA) was introduced in 2009 as a method to prevent lymphedema at the time of axillary lymph node dissection (ALND). We present our early results with a modified LYMPHA technique at the University of Florida.
Methods: We reviewed our prospectively collected database of all patients with a newly diagnosed breast cancer participating in a lymphedema surveillance protocol at our institution from February 2014 to February 2016.
Results: Eighty-seven patients participated in our lymphedema surveillance program during the study period with an average age of 60 years, BMI 30, and follow-up of 11.5 months. Six patients developed lymphedema with the strongest correlation to ALND (p<0.0012). Of eighteen patients who underwent ALND, 10 did not undergo the modified LYMPHA procedure and 8 completed the procedure. Fifty percent of patients who did not undergo the modified LYMPHA procedure developed lymphedema (5 patients). No incidence of lymphedema was detected in patients who underwent the modified LYMPHA procedure. One patient developed lymphedema after sentinel node biopsy and did not undergo modified LYMPHA. (Figure 1)
Conclusion: Our early results demonstrate promising support of the modified LYMPHA procedure in preventing lymphedema in patients undergoing ALND. If these results are maintained in longer follow-up, this will represent a paradigm shift for the lymphatic surgeon to focus on preventative procedures.
