LIPOSUCTION REDUCES ARM LYMPHEDEMA WITHOUT SIGNIFICANTLY ALTERING THE ALREADY IMPAIRED LYMPH TRANSPORT

Abstract

In a prospective study, 20 patients with arm lymphedema after breast cancer treatmentunderwent liposuction combined with Controlled Compression Therapy (CCT) or CCT alone.Indirect lymphoscintigraphy (ILS) was used to study lymph kinetics before and after intervention.Lymphoscintigrams from the contralateral, non-edematous arm were characterized by prompttransit of the radiotracer (99mTc-albumin nanocolloid) to the axillary nodes, whereas traceraccumulation as dermal backflow characterized tracer transport in the lymphedematous arm.Neither liposuction with CCT nor CCT alone, changed this ILS profile. Liposuction combinedwith CCT reduced arm edema volume by (median) 115% (range 92-179%), whereas CCT alonedecreased arm edema volume by only 54% (range 7-81%) (p=0.008). Because liposuction inconjunction with CCT was not associated with further impairment to an already restricted lymphtransport, we recommend this therapy (liposuction with external compression) for chronic armlymphedema, as it reduces edema volume safely, rapidly, and more efficiently than externalcompression alone. Moreover, it does not worsen an already impaired lymph transport in thelymphedematous upper extremity