Early data from a NewYork-Presbyterian/Columbia pilot study suggests that an innovative microsurgery technique helps prevent lymphedema in breast cancer patients. Results from the study have been published in the Annals of Surgical Oncology.
The study of the lymphatic microsurgical preventive healing approach, or LYMPHA, was the first conducted outside of the University of Genoa in Italy, where the technique was developed.
“Even when they are successfully treated, breast cancer patients may still have to live with difficult side effects as a result of techniques used while undergoing care,” said Dr. Sheldon Feldman, chief of the Division of Breast Surgery and the Vivian L. Milstein Associate Professor of Clinical Surgery at NewYork-Presbyterian/Columbia University Medical Center. “While LYMPHA is still a relatively new procedure, we found it to be extremely effective in preventing lymphedema in this pilot study.”
Lymphedema, the accumulation of lymph fluid in the arm and painful swelling due to blocked lymph drainage, occurs in up to 13 percent of breast cancer patients after sentinel node biopsy and external-beam radiation, and up to 40 percent following complete axillary lymph node dissection (ALND) and radiation.
The condition can greatly affect quality of life for breast cancer patients and, can require lifetime treatment with support stockings and manual lymph drainage. LYMPHA was designed to help prevent lymphedema by creating a bypass to restore lymphatic flow by connecting lymph vessels to a branch of the axillary vein, a pathway normally severed by node removal. This preventative bypass is performed immediately after lymph node removal so that the normal lymphatic flow is maintained. It adds about 45 minutes to the lymph node removal procedure and no procedure related side effects have occurred.
In NewYork-Presbyterian/Columbia’s pilot study of the technique, 37 women considered to be at the highest risk for the developing lymphedema underwent LYMPHA. Nearly 90 percent of women in the trial who successfully underwent LYMPHA did not develop lymphedema. In the control group of patients who did not undergo the LYMPHA procedure, 40 percent of the patients have experienced lymphedema that requires ongoing treatment.
While the technique has proven safe and effective thus far, further large-scale multicenter trials will have to be conducted to confirm the efficacy of the procedure. Eventually, LYMPHA could become the standard of care for breast cancer patients needing ALND.
“These results are extremely encouraging,” said Dr. Feldman, who is the study’s principal investigator. “Eventually, LYMPHA could help improve the quality of life for breast cancer patients across the country.”
Please click here to find more information about Dr. Sheldon Feldman.
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