Abstract ES8-1: Options for reducing risk for lymphedema when ALND/regional nodal XRT are needed

Abstract

Abstract Upper extremity lymphedema following axillary lymph node harvest or radiation therapy, can be extremely debilitating and symptomatic in breast cancer patients, and significantly reduces quality of life. In recent years, surgical procedures to reduce the development and progression of lymphedema have become more prevalent. These surgical procedures carry the aim of restoring lymphatic flow in the extremity following disruption of native channels. The most common procedures include vascularized lymph node transfer (VLNT) to the axilla, and lymphaticovenous bypass (LV bypass). The goal of both procedures is to restore flow, and reduce symptoms (infections, cellulitis, and reduced range of motion). VLNT involves harvest and transfer of autologous lymph node packets from a separate area of the body (most frequently the groin or supraclavicular region), and placement into the involved axilla, followed by microsurgical revascularization of the lymph nodes. Through cell signaling, this allows development of new lymphatic channel pathways, and resumption of drainage. LV bypass involves localized microsurgical anastomosis of lymphatic channels in the downstream affected extremity, directly to superficial veins in their vicinity. This allows lymphatic channels, proximal to the site of obstruction, to still drain their collected lymphatic fluid, directly into the systemic venous circulation in the extremity. In most cases, multiple LV bypass anastomoses are performed, to enhance lymphatic outflow. Due to the safety and efficacy of both procedures, they continue to be incorporated more frequently and routinely as part of breast reconstruction treatment plans. Citation Format: H Sbitany. Options for reducing risk for lymphedema when ALND/regional nodal XRT are needed [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr ES8-1.