Liposuction therapy for chronic lymphoedema of the arm after breast cancer

Abstract

Introduction: Breast cancer is the most common disease in women, and up to one third develops lymph oedema of the arm following mastectomy, standard axiliary node dissection and postoperative irradiation. Limb reductions have been reported utilising various conservative therapies such as manual lymph drainage and pressure therapy. In failure of conservative therapy H. Brorosn described encouraging results with liposuction. Liposuction removes the hypertrophied adipose tissue and is a precondition to achieve complete reduction. Methods: In our patient we used the power assisted liposuction to remove the hypertrophied adipose tissue. 15 minimal incisions and cannulas with a diameter of 4 and 3mm were used. Liposuction was executed circumferentially, step-by-step, from hand to shoulder. The incisions where left open to drain. We used the dry method. The arm was held in raised position during the hospital day. Two days postoperatively measurements where taken for custom-made compression garment. Result: In our patient the aspirate volume was 2000ml. The wound healing was uneventful and the liposuction in combination with controlled compression therapy produced a consistent and stable reduction of the chronic arm lymph oedema. The difference of the upper limb circumference from 5cm to 11cm has been achieved. Conclusion: The power assisted liposuction combined with controlled compression therapy is a useful, well working therapy in reduction of arm lymph oedema. Also in older patients it is a very good treatment because of less trauma and the time of surgery.