LYMPHA Technique to Prevent Arm Lymphedema After Breast Cancer Treatment: A Single-Center Study Based on a 15-Year Follow-Up Period.

[BACKGROUND] This study aimed to evaluate the efficacy of the lymphatic microsurgical preventive healing approach (LYMPHA) in preventing lymphedema after axillary lymph node dissection (ALND) for breast cancer.

[METHODS] This retrospective, single-center study analyzed 550 women who underwent axillary lymph node dissection (ALND) between January 2008 and July 2009. The analysis included 500 patients who completed long-term follow-up evaluation. The patients were divided into two groups: 270 patients who underwent ALND with LYMPHA, including 203 who also received radiotherapy and 230 patients who underwent ALND without preventive microsurgical treatment, 173 of whom received radiotherapy. The LYMPHA procedure consisted of performing lymphatic-venous anastomoses at the time of ALND. All the patients were followed up for as long as 15 years with arm volumetry and lymphscanner measurements.

[RESULTS] Arm lymphedema developed in 5 (2.5 %) of the 203 patients who underwent ALND with LYMPHA plus radiotherapy and in 1 (1.5 %) of the 67 patients who underwent ALND with LYMPHA alone. In the group without LYMPHA, lymphedema occurred in 78 (45 %) of the 173 patients who underwent ALND with radiotherapy and in 17 (30 %) of the 57 patients who underwent ALND without radiotherapy. Lymphedema onset occurred 6 to 36 months after surgery. The lymphedema-free cumulative probability was significantly higher in the LYMPHA group than in the no-LYMPHA group (0.978 vs 0.587; p < 0.001). In addition, changes in arm volume relative to baseline at 15 years were significantly lower in the LYMPHA group (p < 0.01).

[CONCLUSIONS] For the primary prevention of secondary arm lymphedema, LYMPHA is an effective technique.