Some women develop swelling of the arm (lymphedema) after axillary node dissection. An axillary node dissection (removal of lymph nodes in the armpit area) is done as part of the treatment or staging for breast cancer. Surgery to the axilla can result in scarring and disruption of lymph channels. Disruption of lymph channels can impair the return of lymph fluid in the arm, which can result in swelling of the arm and infections.
Lymphedema is usually controlled with compressive bandages and massaging of the arm to allay symptoms of arm swelling. Surgery to eliminate lymphedema has historically yielded disappointing results. A newer surgical treatment, microsurgical transfer of a lymph node, has shown some promising results. The procedure was developed by Corinne Becker in 1988. In her study of 24 patients with 5 years of arm lymphedema who underwent microsurgical lymph node transfer to the axilla, 10 patients had normalization of upper arm circumference, 12 patients had decreased arm circumference, and 2 patients had no improvement.
An inguinal lymph node can be transferred to the axilla, together with an abdominal perforator flap microsurgical breast reconstruction in women who have symptoms of arm lymphedema.
A lymph node containing flap can also be transferred by itself to the axilla using microsurgery. Similar to perforator flap reconstruction, this procedure is performed with co-microsurgeons. MR imaging is performed preoperatively to evaluate lymphedema and the lymph flow/nodes to assist with the preoperative plan. Please contact us for more details.
A lymph node containing flap can be transferred to the leg in patients who have leg lymphedema. The lymph node flap can be transferred to the inguinal area and/or above the knee area depending on the physical exam and preoperative MRI results.