Breast cancer patients are at risk for developing postmastectomy lymphedema syndrome of the ipsilateral upper extremity following treatment for breast cancer in the setting of an axillary dissection, postoperative radiation, and chemotherapy. For patients suffering from lymphedema who are also seeking breast reconstruction, combining an autologous abdominal free flap with a vascularized inguinal lymph node transfer provides patients the opportunity to have an aesthetic breast reconstruction as well as the potential to improve their lymphedema in a single operation. The present article aims to provide a description of the salient features of this approach including the preoperative preparation, the surgical technique, the postoperative management and complications, and a summary of the outcomes.
Keywords: DIEP flap and lymph node transfer; breast free flap and lymphedema surgery; breast reconstruction and lymph node transfer; vascularized lymph node transfer.
Conflict of interest statement
Vascularized Lymph Node Transfer for Lymphedema.Semin Plast Surg. 2018 Feb;32(1):28-35. doi: 10.1055/s-0038-1632401. Epub 2018 Apr 9. Semin Plast Surg. 2018. PMID: 29636651 Free PMC article. Review.
Optimizing Quality of Life for Patients with Breast Cancer Related Lymphedema: A Prospective Study Combining DIEP Flap Breast Reconstruction and Lymphedema Surgery.Plast Reconstr Surg. 2020 Jan 7. doi: 10.1097/PRS.0000000000006634. Online ahead of print. Plast Reconstr Surg. 2020. PMID: 31917744
Microvascular breast reconstruction and lymph node transfer for postmastectomy lymphedema patients.Ann Surg. 2012 Mar;255(3):468-73. doi: 10.1097/SLA.0b013e3182426757. Ann Surg. 2012. PMID: 22233832
A Clinical Case of Breast Reconstruction with Greater Omentum Flap for Treatment of Upper Extremity Lymphedema.Plast Reconstr Surg Glob Open. 2019 Sep 30;7(9):e2402. doi: 10.1097/GOX.0000000000002402. eCollection 2019 Sep. Plast Reconstr Surg Glob Open. 2019. PMID: 31942381 Free PMC article.
Comprehensive review of vascularized lymph node transfers for lymphedema: Outcomes and complications.Microsurgery. 2018 Feb;38(2):222-229. doi: 10.1002/micr.30079. Epub 2016 Jun 7. Microsurgery. 2018. PMID: 27270748 Review.