scholarly journals Six-Months Follow-up for Investigating the Effect of Prophylactic Lymphovenous Anastomosis on the Prevention of Breast Cancer-Related Lymphedema: A Preliminary Study in a Single Institution

Author(s):  
Jin A Yoon ◽  
Hyun Seung Lee ◽  
Jae Woo Lee ◽  
Joo Hyoung Kim

Purpose: This study was performed to assess the effect of prophylactic lymphovenous anastomosis on the prevention of arm lymphedema after axillary lymph node dissection for breast cancer treatment.Methods: Among 69 women referred to undergo axillary lymph node dissection from January 2020 to June 2020, 21 were assigned to the treatment group and 48 to the control group. In the treatment group, 21 patients underwent prophylactic lymphovenous anastomosis for the prevention of breast cancer-related lymphedema. The other 48 patients in the control group did not undergo any preventive surgical treatment. Prophylactic lymphovenous anastomosis was performed at the same time as axillary lymph node dissection and breast cancer surgery. Postoperatively, all patients underwent circumferential measurements at 1, 3, and 6 months and lymphography at 6 months after the surgery. Results: None of the patients in the treatment group had lymphedema after the surgery (0%). In the control group, lymphedema occurred in nine patients (18.8%, p=0.049). No significant differences in the arm circumference were observed in the treatment group during follow-up (p>0.05), whereas the arm circumference in the control group showed a significant increase at 1, 3, and 6 months after axillary lymph node dissection (p<0.05). There were no significant differences between the two groups in the arm circumference changes with respect to baseline at 1, 3, and 6 months after axillary lymph node dissection (p>0.05). Conclusion: Prophylactic lymphovenous anastomosis represents a valid super microsurgical technique for the primary prevention of breast cancer-related lymphedema.

Breast Cancer ◽  
2012 ◽  
Vol 20 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Masakuni Noguchi ◽  
Emi Morioka ◽  
Yukako Ohno ◽  
Miki Noguchi ◽  
Yasuharu Nakano ◽  
...  

Breast Cancer ◽  
2019 ◽  
Vol 27 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Yoshiteru Akezaki ◽  
Eiji Nakata ◽  
Masato Kikuuchi ◽  
Ritsuko Tominaga ◽  
Hideaki Kurokawa ◽  
...  

2019 ◽  
Vol 18 ◽  
pp. 153303381882110 ◽  
Author(s):  
Willard Wong ◽  
Illana Rubenchik ◽  
Sharon Nofech-Mozes ◽  
Elzbieta Slodkowska ◽  
Carlos Parra-Herran ◽  
...  

Background: Shift toward minimizing axillary lymph node dissection in patients with breast cancer post neoadjuvant therapy has led to the assessment of sentinel lymph nodes by frozen section intraoperatively to determine the need for axillary lymph node dissection. However, few studies have examined the accuracy of sentinel lymph node frozen section after neoadjuvant therapy. Our objective is to compare the accuracy of sentinel lymph node frozen section in patients with breast cancer with and without neoadjuvant therapy and to identify features that may influence accuracy. Design: We identified 161 sentinel lymph node frozen section from 77 neoadjuvant therapy patients and 255 sentinel lymph node frozen section from 88 non-neoadjuvant therapy patients diagnosed between 2010 and 2016 in 2 institutions. The frozen section diagnoses were compared to the final diagnoses, and clinicopathologic data were analyzed. Results: The sensitivity, specificity, and accuracy of frozen section analysis were comparable between neoadjuvant therapy patients and non-neoadjuvant therapy patients (71.9% vs 50%, 100% vs 100%, and 88.3% vs 81.8%). Nine (11.7%) of 77 neoadjuvant therapy patients had discordant results, most often due to undersampling (tumor absent on frozen section slide). Four of these patients subsequently underwent axillary lymph node dissection. Discordant results (all false negatives) were significantly more likely in neoadjuvant therapy patients with Estrogen Receptor-positive/HER2-negative status, and in sentinel lymph node with pN1mic and pN0i+ deposits; age, preneoadjuvant therapy lymph node status, histotype, nuclear grade, tumor size, and response to neoadjuvant therapy showed no significant differences. For non-neoadjuvant therapy cases, large tumor size, lobular histotype, and sentinel lymph node with pN1mic and pN0i+ were associated with false-negative frozen section assessment. Conclusion: Sentinel lymph node frozen section diagnosis post-neoadjuvant therapy has comparable sensitivity, specificity, and accuracy to the sentinel lymph node frozen section diagnosis in the non-neoadjuvant therapy setting.


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