370P - LYMPHA surgery to reduce lymphedema following axillary node clearance: A new study at a London plastics centre

Background

LYMPHA is a relatively new surgical technique that dramatically reduces the incidence of lymphedema following axillary node clearance in breast cancer patients. The technique identifies dominant lymph vessels draining the arm with the aid of dye and, following clearance of the axillary nodes, anastomosing lymphatic vessels to a branch of the axillary vein to enable free drainage of lymphatic fluid. Not currently widely available to breast cancer patients in the UK, this simple surgical procedure carried out at the time of axillary node clearance has been shown to reduce the incidence of lymphedema from 25% to 4%. We report on the establishment of a LYMPHA service at a major London Plastics Centre and first 2 years of its outcomes.

Methods

Suitable patients were referred to plastics by the breast surgery team and seen preoperatively to discuss LYMPHA. Upon agreeing to the procedure, pre-operative measurements of arm volume and arm bioimpedance were completed as well as screening questionnaires on symptoms of lymphedema. Subsequent to the procedure the two measurements and the questionnaires were repeated at 1, 3, 6, 12 and 24 month intervals.

Results

Of 16 patients that have undergone the LYMPHA procedure 0 have experienced signs or symptoms of lymphedema to date. One patient suffered temporary swelling of the arm 1-month post-op which subsequently resolved. No patients have suffered any complications relating to LYMPHA. 1 patient withdrew due to metastatic disease recurrence. The patients enrolled have been followed up for between 3-23 months with a current mean follow up time of 12.61 months.

Conclusions

Our findings thus far support current evidence that LYMPHA surgery is both safe and effective in reducing the incidence of lymphedema. This pilot study is currently being developed into an RCT which will add to the evidence base of this relatively niche area of plastic surgery.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.