Treating
chronic lymphedema after
breast cancer therapy
What is the treatment for chronic lymphedema after breast cancer?
Unfortunately, lymphedema cannot heal on its own. It is a chronic, meaning long-term disease, but it can be treated with patience and determination.
There are two types of treatment for chronic lymphedema following breast cancer therapy: Conservative therapy without surgery and therapy with surgery.
Patient and trial participant, Karin Brutschin, wearing a compression sleeve
Conservative therapy
The most common treatment for chronic lymphedema after breast cancer therapy is conservative therapy. This therapy is called Complete Decongestive Therapy (CDT) and is divided into two phases:
Phase 1 / Intensive Phase:
In the first phase, the main aim is to reduce swelling, using manual lymphatic drainage, compression bandages, exercise therapy and skin care.
Phase 2 / Maintenance Phase:
Phase 2 focuses on maintaining the results from phase 1. Self-care management is key (see “Understanding lymphedema”). Wearing a compression stocking every day helps prevent the swelling from getting worse, and regular check-ups are important.
Surgical therapy
Surgical therapies for chronic lymphedema following breast cancer treatment are used in combination with conservative therapy. Lymphovenous anastomosis (LVA) and vascularised lymph node transplantation (VLNT) are (super) microsurgical treatment methods in lymphatic surgery. These procedures aim not only to alleviate the symptoms, but also to eliminate the causes of lymphedema. Visible improvements in the affected extremities typically manifest over the course of several weeks to months.
Lymphovenous
anastomosis (LVA)
In this microsurgical technique, lymphatic vessels are connected directly to small, nearby veins. The aim is to create a new pathway for lymph flow to reduce the swelling caused by the lymphedema. This technique can be particularly effective in the early stages of lymphedema.
Vascularized lymph
node transplantation
(VLNT)
In this procedure, lymph nodes are removed from another part of the body where they are sufficiently present and transplanted into the affected area of lymphedema. The aim is to restore functioning lymphatic drainage in the affected area. This can reduce the swelling.
Liposuction
Liposuction can be used in combination with the microsurgical treatments (LVA and VLNT). Liposuction removes excess fat and connective tissue that have accumulated in the affected areas. It helps to quickly reduce swelling in the affected area and restore the patient’s body shape.