The Surgeon Minute

Lymphedema Treatment after Breast Cancer

Lymphedema Treatment after Breast Cancer

When a patient receives the tragic news of cancer — protocols are immediately put into place. However, even following cancer recovery there can be unforeseen post traumatic medical problems. At the hands of board certified plastic surgeon, Robert Whitfield, MD, FACS and his partner Ned Snyder IV, MD of Breast and Body Center of Austin, patients who are coping with lymphedema are treated with the latest instruments and technology available.

Robert Whitfield, MD, FACS
Interviewed by:
The Plastic Surgery Channel

lymbreast3What is Lymphedema?

Lymphedema refers to swelling that generally occurs in one of your arms or legs. In some cases, there is swelling in both.

The condition most commonly develops after the removal of, or damage to lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling.

“Lymphedema is incredibly debilitating, and we’re seeing this condition a lot from breast cancer patients treated in the 90’s,” says Robert Whitfield, MD. “The arm becomes heavy, with fat and fluid building up. It can add five to ten pounds to a person’s limb, making it a huge burden for the patient.”

Your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste products. Your lymphatic system carries this fluid and harmful substances through your lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes — infection-fighting cells that live in your lymph nodes — and ultimately flushed from your body.

Traditional v. Modern Treatment

Typical treatment has always been massage, compression garments, and sleeves. While there is no cure, standard care for lymphedema includes physical therapy to decrease pain and improve mobility as well as the use of pressure garments to keep lymph fluid moving.

New developments include a product called flexitouch.  “It’s remarkable, we are now at a point where we zoom in to connect lymphatic vessels – and ultimately drain fluid — decreasing swelling in the hand,” says Whitfield.

mitakaLymphatic Surgery

“The first step is to seek out treatment. In many instances, early and aggressive lymphatic massage can control the edema. If it doesn’t, we have the instruments and microscope to perform the surgery.  We now have one of the few microscopes in the United States called the Mitaka. This high resolution microscope allows you to operate on the structures less the 1mm. It has 42X magnification, with 8:1 zoom,” says Whitfield.

Patient selection is still key though. The best candidates are those who we can perform a DIEP flap reconstruction on — as well as lymph node transfer and lymphaticovenous bypass.  Whitfield explains, “Once you’ve been evaluated for surgery and considered compliant, it can make a huge difference in your overall lifestyle and that’s our ultimate goal!”

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