VASCULARIZED LYMPH NODE TRANSFER FOR TREATMENT OF BREAST CANCER-RELATED LYMPHEDEMA: INDICATIONS, DONOR SITES AND COMPLICATIONS

Abstract

Breast cancer-related lymphedema (BCRL) is as a burden for patients treated for breast cancer. Despite its main ma­nagement being focused on conservative methods, mode­rate or severe cases may be resistant and require surgical treatment. One of the commonly used techniques is vas­cularized lymph node transfer (VLNT) which allows the relocation of normal lymph nodes to the affected limb to ensure proper lymph flow, thus relieving lymphedema. The donor site is chosen based on the risk of iatrogenic lymphedema and scarring. Despite the inguinal region has a great risk for donor site lymphedema, it is the most common donor site due to its well-hidden scar, defined anatomy, abundant lymph nodes and soft tissue. Other following donors sites by frequency are axillary-thoracic, supraclavicular, omental, and submental. Complications that often follow VLNT are donor site lymphedema, soft tissue infection, scarring, hematoma, and nerve injury.