The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study
Background: Immediate lymphatic reconstruction (ILR) has emerged as an effective intervention to reduce breast cancer-related lymphedema, which affects 2–30% of patients who undergo axillary lymph node dissection (ALND). Our previous research validated ILR’s effectiveness over 14 months, but the du...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Medical Journals Sweden
2025-06-01
|
| Series: | Journal of Plastic Surgery and Hand Surgery |
| Subjects: | |
| Online Access: | https://medicaljournalssweden.se/JPHS/article/view/43738 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849224375390175232 |
|---|---|
| author | Ki-Jae Kim Sun-Hyeok Kim Seung-Pil Jung Eul-Sik Yoon Jae-Ho Chung |
| author_facet | Ki-Jae Kim Sun-Hyeok Kim Seung-Pil Jung Eul-Sik Yoon Jae-Ho Chung |
| author_sort | Ki-Jae Kim |
| collection | DOAJ |
| description |
Background: Immediate lymphatic reconstruction (ILR) has emerged as an effective intervention to reduce breast cancer-related lymphedema, which affects 2–30% of patients who undergo axillary lymph node dissection (ALND). Our previous research validated ILR’s effectiveness over 14 months, but the duration was short and warranted further study. This study provides long-term evidence of its benefits in a well-defined patient cohort.
Method: This retrospective cohort study included unilateral breast cancer patients who underwent ALND between November 2019 and February 2021 with ≥ 24 months of follow-up. Patients were grouped by whether ILR was attempted intraoperatively. Exclusion criteria were recurrence, prophylactic mastectomy, and pre-existing lymphedema. The primary outcome was lymphedema incidence at ≥ 24 months; the secondary was lymphedema-free survival. Outcomes were evaluated using Cox regression models.
Results: Among 73 patients, we analyzed ALND patients divided into a control group (n = 57, defined as no-try or failure) and an ILR group (n = 16). The pooled median follow-up was 37 months. (range, 26~47 months). Among the ILR group, 13 underwent end-to-end anastomosis and 3 end-to-side. Postoperative lymphedema was higher in the control group (24.6%) compared to the ILR group (6.3%). Multivariate Cox regression analysis showed a significantly lower hazard ratio for the ILR group (HR: 0.117, 95% CI: 0.014–0.965), emphasizing ILR’s effectiveness in reducing lymphedema risk post-ALND. Additionally, survival plots illustrating lymphedema-free survival showed a significant difference.
Conclusion: Our study emphasizes ILR’s efficacy over extended follow-up. The ILR group exhibited a lower rate of postoperative lymphedema, supporting ILR as an effective preventive measure against Breast Cancer-Related Lymphedema (BCRL) following ALND.
|
| format | Article |
| id | doaj-art-7d4dc9251db245e99a1ee7ebdc0de618 |
| institution | Kabale University |
| issn | 2000-6764 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Plastic Surgery and Hand Surgery |
| spelling | doaj-art-7d4dc9251db245e99a1ee7ebdc0de6182025-08-25T11:15:56ZengMedical Journals SwedenJournal of Plastic Surgery and Hand Surgery2000-67642025-06-0160110.2340/jphs.v60.43738The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up studyKi-Jae Kim0Sun-Hyeok Kim1Seung-Pil Jung2Eul-Sik Yoon3Jae-Ho Chung4Department of Plastic and Reconstructive Surgery, Korea University Hospital, Seoul, Republic of KoreaDepartment of Plastic and Reconstructive Surgery, Korea University Hospital, Seoul, Republic of KoreaDivision of Breast and Endocrine Surgery, Korea University Hospital, Seoul, Republic of KoreaDepartment of Plastic and Reconstructive Surgery, Korea University Hospital, Seoul, Republic of KoreaDepartment of Plastic and Reconstructive Surgery, Korea University Hospital, Seoul, Republic of Korea; Institute of Advanced Regeneration and Reconstruction, College of Medicine, Korea University, Seoul, Republic of Korea Background: Immediate lymphatic reconstruction (ILR) has emerged as an effective intervention to reduce breast cancer-related lymphedema, which affects 2–30% of patients who undergo axillary lymph node dissection (ALND). Our previous research validated ILR’s effectiveness over 14 months, but the duration was short and warranted further study. This study provides long-term evidence of its benefits in a well-defined patient cohort. Method: This retrospective cohort study included unilateral breast cancer patients who underwent ALND between November 2019 and February 2021 with ≥ 24 months of follow-up. Patients were grouped by whether ILR was attempted intraoperatively. Exclusion criteria were recurrence, prophylactic mastectomy, and pre-existing lymphedema. The primary outcome was lymphedema incidence at ≥ 24 months; the secondary was lymphedema-free survival. Outcomes were evaluated using Cox regression models. Results: Among 73 patients, we analyzed ALND patients divided into a control group (n = 57, defined as no-try or failure) and an ILR group (n = 16). The pooled median follow-up was 37 months. (range, 26~47 months). Among the ILR group, 13 underwent end-to-end anastomosis and 3 end-to-side. Postoperative lymphedema was higher in the control group (24.6%) compared to the ILR group (6.3%). Multivariate Cox regression analysis showed a significantly lower hazard ratio for the ILR group (HR: 0.117, 95% CI: 0.014–0.965), emphasizing ILR’s effectiveness in reducing lymphedema risk post-ALND. Additionally, survival plots illustrating lymphedema-free survival showed a significant difference. Conclusion: Our study emphasizes ILR’s efficacy over extended follow-up. The ILR group exhibited a lower rate of postoperative lymphedema, supporting ILR as an effective preventive measure against Breast Cancer-Related Lymphedema (BCRL) following ALND. https://medicaljournalssweden.se/JPHS/article/view/43738Lymphedemaaxillary reverse mappinglymphovenous anastomosis |
| spellingShingle | Ki-Jae Kim Sun-Hyeok Kim Seung-Pil Jung Eul-Sik Yoon Jae-Ho Chung The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study Journal of Plastic Surgery and Hand Surgery Lymphedema axillary reverse mapping lymphovenous anastomosis |
| title | The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study |
| title_full | The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study |
| title_fullStr | The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study |
| title_full_unstemmed | The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study |
| title_short | The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study |
| title_sort | efficacy of immediate lymphatic reconstruction in preventing breast cancer related lymphedema long term follow up study |
| topic | Lymphedema axillary reverse mapping lymphovenous anastomosis |
| url | https://medicaljournalssweden.se/JPHS/article/view/43738 |
| work_keys_str_mv | AT kijaekim theefficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT sunhyeokkim theefficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT seungpiljung theefficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT eulsikyoon theefficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT jaehochung theefficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT kijaekim efficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT sunhyeokkim efficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT seungpiljung efficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT eulsikyoon efficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy AT jaehochung efficacyofimmediatelymphaticreconstructioninpreventingbreastcancerrelatedlymphedemalongtermfollowupstudy |