Breast cancer patients who underwent axillary lymph node dissection following radiotherapy are at a higher risk of developing extremity lymphedema – Breast Cancer-Related Lymphedema (BCRL), a condition that results in tissue swelling and liquid retention in the arms. While it is possible to manage the condition with some home care, surgery may be necessary to significantly improve an individual’s comfort and quality of life. Ming-Heui Cheng, MD, FACS, a pioneer in plastic microsurgery and internationally renowned lymphedema specialist, performs vascularized lymph node flap transfers on lymphedema patients whose symptoms have not improved or continue to worsen six months after they emerged.
The affected limb may develop inflammation, infection, adipogenesis, and fibrosis of the tissue. The protein-concentrated fluid that accumulates inside the interstitial tissue may further block or make the drainage of the lymph fluid less efficient or even create an obstruction. Lymphedema of upper extremity causes pain, heaviness, skin hyperkeratosis, fibrosis, discomfort when wearing certain clothes and jewelry, cosmetic problems and limitation of daily activities for patients. It is common for lymphedema patients to experience depression, due to physical discomfort, emotional distress and lower quality of life.
The indications, contraindications, and algorithm for selection of recipient site for the vascularized groin lymph node flap transfer. VGLN, vascularized groin lymph node; ISL,International Society of Lymphedema; Tc-99, technetium-99.
LVA is an advanced minimally invasive super-microsurgical technique used to relieve lymphedema. During the procedure, Dr. Cheng will make small incisions, which expose lymphatic channels and small veins just beneath the skin.
In some cases, surgery may be performed to alleviate swelling and reduce symptoms. Dr. Cheng has developed a unique technique that involves lymph node transfer. During the procedure, Dr. Cheng transfers lymph node flap to distal recipient site – dorsal wrist in the upper extremity or ankle in the lower extremity.
If you have Breast Cancer Related Lymphedema and would like to know more about the most advanced treatments, contact Dr. Cheng. Internationally recognized as a leading lymphedema specialist, Dr. Cheng can discuss treatment options, based on your individual case. Dr. Cheng is a member of the American Society of Reconstructive Microsurgery and has performed numerous VLN surgeries on breast cancer survivors and other lymphedema patients.