New Surgical Procedure May Prevent Lymphedema

Developed in Italy, the procedure is now being tested in the United States and could prevent the inconvenience and discomfort of lymphedema.

For women who have undergone surgery for advanced-stage breast cancer, lymphedema can be a lifelong problem. In an attempt to limit the spread of cancer, surgeons often remove many lymph nodes from the underarms and arms as part of the treatment. Lymph nodes under the arm drain lymph from the breast.

Lymph is a liquid that transports bacteria and waste out of the soft tissue of the breast. Cancer would most likely be found there first. Removing the lymph node and the normal buildup of fibrous connective tissue after radiation treatment can result in the retention of fluid and swelling.

This fluid buildup can lead to severe swelling, inflammation and possible skin infection, if not treated with massage and compressive wrapping. A small clinical trial testing the safety and effectiveness of a new technique is taking place at the New York-Presbyterian/Columbia University Medical Center. The new procedure could spare patients the inconvenience and discomfort of lymphedema.

Breast-surgery division chief at Columbia University, Dr. Sheldon Marc Feldman and his colleagues are halfway through a study of a LYMPHA technique on a dozen patients. They plan to use the lymphatic microsurgical preventive healing approach procedure on 30 patients in all. Then, in collaboration with several other major medical institutions, initiate a large-scale study. The technique involves creating a bypass to restore lymphatic flow. It was developed by Dr. Corradino Campisi and Dr. Francesco Boccardo at the University of Genoa in Italy.

Feldman visited Italy to watch the surgeons use the technique. “It’s actually the only medical institution in the world that has a division of lymphatic surgery. They’ve done a lot of the groundwork on lymphatic techniques,” said Feldman. “The good news is that even with patients with advanced disease, most of these patients are being cured of breast cancer. We are curing them of their cancer, but if they develop lymphedema, they have serious quality-of-life issues.”

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