title: Clinical and Psychosocial Outcomes of Vascularized Lymph Node Transfer for the Treatment of Upper Extremity Lymphedema After Breast Cancer Therapy.
abstract: BACKGROUND: Secondary lymphedema following breast cancer therapy remains a major problem. Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema that has shown promising results, but limited studies in the United States have investigated outcomes for single-stage VLNT to the axilla. The goal of this prospective, ongoing study was to investigate the clinical, psychosocial, and functional outcomes of patients who underwent VLNT for the treatment of upper extremity lymphedema after breast cancer therapy.
  
  
  METHODS
  VLNT to the axilla were performed on patients with upper extremity lymphedema after breast cancer therapy. Patients were evaluated preoperatively and postoperatively at 1-, 3-, 6-, 9-, and 12-month intervals by circumferential measurements, pain/heaviness scales, and the LYMQOL questionnaire.
  
  
  RESULTS
  Fifty patients met the study criteria. Preliminary results showed a decrease in arm volumes by 34.57 % at 1 month, 52.03 % at 3 months, 42.34 % at 6 months, 65.23 % at 9 months, and 58.68 % at 12 months. Pain and heaviness consistently decreased over time to 0.38 and 1.67 respectively at 12 months. Overall quality of life scores steadily improved from 5.72 preoperatively to 7.79 at 12 months. There was a significant decrease in the number of infections of the affected arm postoperatively and a decreased need for physiotherapy. Complications occurred in 17 patients and consisted mainly of minor wound complications.
  
  
  CONCLUSIONS
  VLNT continues to demonstrate its value as a safe and effective treatment option for lymphedema after breast cancer therapy. Significant reductions in volume are accompanied by a decrease in symptoms and improvement in quality of life.
authors.affiliation: Orlando Health, Orlando, FL, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gratzon
authors.affiliation: University of Central Florida College of Medicine, Orlando, FL, USA.
authors.forename: Jerette
authors.initials: J
authors.lastname: Schultz
authors.affiliation: Orlando Health, Orlando, FL, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Secrest
authors.affiliation: Orlando Health, Orlando, FL, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lee
authors.affiliation: Orlando Health, Orlando, FL, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Feiner
authors.affiliation: Orlando Health, Orlando, FL, USA. richard.klein@orlandohealth.com.|Center for Reconstructive Surgery, UF Health Cancer Center at Orlando Health, Orlando, FL, 32806, USA. richard.klein@orlandohealth.com.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D000072656:Breast Cancer Lymphedema / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D001943:Breast Neoplasms / Q000098:blood supply / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000098:blood supply* / Q000637:transplantation*; D008408:Mastectomy / Q000009:adverse effects; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D034941:Upper Extremity / Q000473:pathology / Q000601:surgery*