title: Lymphatic mapping and lymphedema surgery in the breast cancer patient.
abstract: Upper limb lymphedema can be an unfortunate sequela following the oncologic treatment of breast cancer. The surgical treatment of lymphedema has had a recent renewed clinical interest paralleling innovative descriptions of surgical techniques and imaging modalities. In addition, an improved understanding of the physiology and pathophysiology of lymphedema has allowed improved translation to the clinical condition. Various surgical options exist to decrease the symptom-burden of upper limb lymphedema, including vascularized lymph node (VLN) transfer, lymphovenous bypass (LVB), liposuction, lymphatic grafting, and excisional procedures. Modern imaging techniques help to improve the consistency and accuracy of these surgical treatment options. A multi-modal treatment plan utilizing non-operative and surgical therapies has the potential to improve various factors related to overall patient quality of life. This review details all of the current operative treatment strategies and modern imaging modalities used in the treatment of lymphedema.
authors.affiliation: 1 Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA ; 2 Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA ; 3 Department of Occupational Therapy, 4 Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Ketan M
authors.initials: KM
authors.lastname: Patel
authors.affiliation: 1 Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA ; 2 Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA ; 3 Department of Occupational Therapy, 4 Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Oscar
authors.initials: O
authors.lastname: Manrique
authors.affiliation: 1 Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA ; 2 Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA ; 3 Department of Occupational Therapy, 4 Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Sosin
authors.affiliation: 1 Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA ; 2 Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA ; 3 Department of Occupational Therapy, 4 Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Mahjabeen Aftab
authors.initials: MA
authors.lastname: Hashmi
authors.affiliation: 1 Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA ; 2 Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA ; 3 Department of Occupational Therapy, 4 Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Poysophon
authors.initials: P
authors.lastname: Poysophon
authors.affiliation: 1 Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA ; 2 Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA ; 3 Department of Occupational Therapy, 4 Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Henderson
keywords: Lymphatic mapping; liposuction; lymphatic grafting; lymphatic surgery; lymphedema; lymphovenous bypass (LVB); microsurgery; vascularized lymph node (VLN) transfer