No more pain and swelling: Preventing lymphedema

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There are more than 3.5 million breast cancer survivors in the U.S., and one in five of those will be diagnosed with lymphedema, a painful swelling, usually in one or both arms.

But there's a new supermicrosurgical procedure that may prevent it.

Breast cancer survivor Veda Jackson picked up crocheting about a year ago.

"I started crocheting because I needed to do something with my hands because I was anxious all the time," she said.

She got needles and yarn and got hooked. It took her mind off her diagnosis.

"I was diagnosed with Stage 3 metastasis breast cancer because it had spread to my lymph nodes," she recalled.

"The lymphatic fluid that is all part of our body can no longer drain the arm, and as a result, it resides in the arm and causes a lot of swelling," plastic surgeon Dr. Christopher Reid said.

The gold standard for preventing lymphedema is wearing a compression sleeve to stop swelling.

At the time of the mastectomy, surgeons are using immediate lymphatic reconstruction to prevent it from happening at all. Reid "replumbs" the drainage routes of the nodes.

Using a microscope, Reid reconnects any disrupted channels. Many are smaller than the size of a single strand of hair.

Other than adding time in the operating room, Reid says there is no additional risk to the patient.

"If I had a family member, a mother, a sister, a friend who was undergoing breast cancer therapy, I would 100% offer this to them. Because if we can eliminate lymphedema altogether, why not try this?" Reid said.

Jackson had a total of 16 chemo treatments and was on 13 medications. The treatments worked – no lymphedema.

"I feel great," she said. "Oh, no, I feel great. Blessed, wonderful. All of those things."

Today she's spending less time at work, thankful she has this time with family.

Breast cancer patients who are getting radiation or are obese have a greater risk of developing lymphedema. This technique may also be used to prevent leg lymphedema caused by lymph node removal in the groin area.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: NO MORE PAIN AND SWELLING! PREVENTING LYMPHEDEMA
REPORT: MB #4702

BREAST CANCER: Next to skin cancer, breast cancer is the second most common cancer diagnosed in women in the US. It can occur in men as well, but it is found more often in women. Substantial support for awareness and research has helped advance diagnosing and treatment options. Survival rates have increased, and the number of deaths associated with the disease is declining, largely due to factors like earlier detection. Symptoms may include a breast lump or thickening in an area of tissue, change in shape or size of breast, a newly inverted nipple, and peeling or crusting of skin surrounding nipple. Risk factors include but are not limited to increasing age, a personal or family history of breast conditions or breast cancer, radiation exposure, even obesity and beginning your period at an earlier age. You can make changes in your daily life that may help reduce your risk of breast cancer, such as; self- breast exams, drink alcohol in moderation if at all (limit to one drink a day), exercise most days of the week, limit hormone therapy, maintain a healthy weight and choose a healthy diet. (Source: https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470)

LYMPHEDEMA: A lymphatic obstruction or lymphedema is a condition where excess fluid collects in tissues causing swelling. It is incurable, but with the right treatment it can be controlled. In some cases, it can lead to skin infections and lymphangitis; an inflammation of the lymphatic system. Complex decongestive therapy can help treat symptoms, and involves things like remedial exercise, skincare, manual lymphatic drainage, or multilayer bandaging. Secondary lymphedema can be caused as a result of cancer surgery, when surgeons remove lymph nodes to stop the spread of cancer. Radiation therapy can also destroy cancerous tissue but damage nearby healthy tissue as well, such as the lymphatic system. (Source: https://www.medicalnewstoday.com/articles/180919.php#causes)

NEW PREVENTION SURGERY: Previously, when breast cancer surgeries would result in lymphatic system injuries, doctors would take measures to treat this post surgery. Now there is a way to prevent it, using supra micro surgical techniques. "Essentially we find lymphatics that we think potentially are damaged during the breast cancer surgery, no fault to the breast surgeon doing the operation, and then we drain them into the venous system or the veins in the armpit to allow the arm some way to drain this limb. And as long as it can stay open, hopefully they never go on to develop lymphedema." Other than adding more time in the operating room, there is no real risk to the patient undergoing this therapy. (Source: Christopher Reid, MD)