To evaluate the use of axillary vascular grafts in performing prophylactic lymphovenous bypass (pLVB) during axillary lymph node dissection (ALND) to prevent breast cancer-related lymphedema (BCRL), highlighting its significance in improving patient outcomes.
Key Findings:
32 patients with a mean age of 52.3 years and median BMI of 26.9 kg/m2 were included, with a median follow-up duration of 15 months.
74.8% of reconstructions required interposition grafts due to transected lymphatic vessels.
35 grafts were performed, with 74.3% being venous and 25.7% arterial.
BCRL developed in 18.8% of patients, with a higher mean number of lymph nodes removed in affected patients.
Interpretation:
Axillary vascular grafting is effective in enabling lymphatic reconstruction in vein-depleted axillae, potentially reducing the incidence of BCRL in high-risk patients, which could significantly impact clinical practice.
Limitations:
Retrospective design may introduce bias, affecting the reliability of the findings.
Limited follow-up duration for some patients may not capture long-term outcomes.
Conclusion:
Axillary-based vascular grafting enhances the capacity for immediate lymphatic reconstruction during pLVB, representing a practical solution for high-risk breast cancer patients without additional donor-site morbidity, potentially improving patient outcomes.
