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      The Post-Operative Mammographic Appearance of Lymphovenous Bypass and Vascularized Lymph Node Transfer ☆

      case-report

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          Abstract

          The postoperative mammographic imaging appearance related to lymphovenous bypass and vascularized lymph node transfer has not been described. It is important for breast imagers to become familiar with the expected appearance of surgical changes that can be seen in the follow up imaging of breast cancer survivors in order to create accurate reports and adjust imaging protocols to improve imaging quality and lessen patient discomfort as needed.

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          A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema.

          David Chang, Hiroo Suami, Roman J Skoracki (2013)
          The authors prospectively evaluated the efficacy of lymphovenous bypass in patients with lymphedema secondary to cancer treatment.
          Article 0 comments Cited 118 times – based on 0 reviews     Review now
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            Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities.

            K Urushibara, I Koshima, T Moriguchi … (2000)
            Over the last eight years, the authors analyzed obstructive lymphedema of a unilateral upper extremity in a total of 27 females, comparing the use of supramicrosurgical lymphaticovenule anastomoses and/or conservative treatment. The most common cause of edema was mastectomy, with or without subsequent radiation therapy for breast cancer. As an objective assessment of the extent of edema, the circumferences of the affected and opposite normal forearms were measured at 10 cm below the olecranon of the arm. Twelve of these patients received continual bandaging. In these patients, the average excess circumference of the affected arm was 6.4 cm over that of the normal forearm; the average duration of edema before treatment was 3.5 years; the average period for conservative treatment was 10.6 months; and the average decrease in circumference was 0.8 cm (11.7 percent of the preoperative excess). Twelve patients underwent surgery and postoperative continual bandaging. In these patients, the average excess circumference was 8.9 cm; the average duration of edema before surgery was 8.2 years; the average follow-up after surgery was 2.2 years; and the average decrease in circumference was 4.1 cm (47.3 percent of the preoperative excess). These results indicated that supermicrolymphaticovenular anastomoses with postoperative bandaging have a valuable place in the treatment of obstructive lymphedema.
            Article 0 comments Cited 81 times – based on 0 reviews     Review now
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              Lymphaticovenular bypass for lymphedema management in breast cancer patients: a prospective study.

              Rowland Chang (2010)
              Lymphedema is a common and debilitating condition. Management options for lymphedema are limited and controversial. The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients. Twenty patients with upper extremity lymphedema secondary to treatment of breast cancer underwent lymphaticovenular bypass using a "supermicrosurgical" approach. The mean age of the patients was 54 years, 16 patients had received preoperative radiation therapy, and all patients had received axillary lymph node dissection. The mean duration of lymphedema was 4.8 years, and the mean volume differential of the lymphedematous arm compared with the unaffected arm was 34 percent. Evaluation included qualitative assessment and quantitative volumetric analysis before surgery and at 1 month, 3 months, 6 months, and 1 year after the procedure. The mean number of bypasses performed per patient was 3.5 (range, two to five), and the size of bypasses ranged from 0.3 to 0.8 mm. The mean operative time was 3.3 hours (range, 2 to 5 hours). Hospital stay was less than 24 hours for all patients. The mean follow-up time was 18 months. Nineteen patients (95 percent) reported symptom improvement following surgery, and 13 patients had quantitative improvement. The mean volume differential reduction was 29 percent at 1 month, 36 percent at 3 months, 39 percent at 6 months, and 35 percent at 1 year. No patients experienced postoperative complications or lymphedema exacerbation. Lymphaticovenular bypass may effectively reduce the severity of lymphedema in breast cancer patients. Long-term analysis is needed.
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                Author and article information

                Contributors
                Emily S. Nia
                Journal
                Journal ID (nlm-ta): Radiol Case Rep
                Journal ID (iso-abbrev): Radiol Case Rep
                Title: Radiology Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 1930-0433
                Publication date PMC-release: 05 August 2022
                Publication date Collection: October 2022
                Publication date (Electronic): 05 August 2022
                Volume: 17
                Issue: 10
                Pages: 3760-3762
                Affiliations
                [a ]Department of Breast Imaging, M.D. Anderson Cancer Center, Houston, TX, USA
                [b ]Department of Plastic Surgery, M.D. Anderson Cancer Center, Houston, TX, USA
                Author notes
                [* ]Corresponding author. esnia@ 123456mdanderson.org
                Article
                Publisher Item ID: S1930-0433(22)00614-8
                DOI: 10.1016/j.radcr.2022.07.069
                PMC ID: 9363951
                SO-VID: 109b8dde-0956-46d7-8449-46b3b063af0c
                Copyright © © 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 19 June 2022
                Date accepted : 14 July 2022
                Categories
                Subject: Case Report

                Keywords: lymphovenous bypass,lymph node transfer,mammogram,breast imaging,foreign body
                Data availability:
                Keywords: lymphovenous bypass, lymph node transfer, mammogram, breast imaging, foreign body

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