Gentle new method against lymphoedema

Every year, over 6000 women in Switzerland are newly diagnosed with breast cancer. Thanks to advances in the treatment of the disease, around 90 per cent of breast cancer patients are still alive five years after their initial diagnosis. But even if the cancer symptoms subside temporarily or permanently, the burden for those affected is often not over. Because: "Up to a third of patients develop lymphoedema after breast cancer surgery," says Prof. Dr Mario Scaglioni, co-chief physician and co-owner of the Plastic Surgery Pyramid in Zurich.

Often after breast cancer surgery

Lymphoedema is a chronic and often painful condition. The accumulation of lymph fluid can lead to swelling in the limbs. Between 50,000 and 100,000 people in Switzerland live with this condition. Lymphoedema is particularly common in women who have had lymph nodes removed or damaged during breast cancer surgery. It therefore most frequently develops in the arm on the side where the breast operation took place. "As a result, the lymphatic system of the upper arm is no longer able to remove the fluid sufficiently."

Conservative therapy

Traditionally, lymphoedema is treated conservatively. The most common treatment is so-called complex physical decongestive therapy, which consists of a reduction and a maintenance phase. The aim of the reduction phase is a combination of manual lymphatic drainage, compression bandages, exercise therapy and skin care. This is followed by the maintenance phase with compression garments, self-massage, exercise therapy and skin care. The aim is to prevent relapses. However, as lymphoedema is a chronic disease, the condition can progress despite conservative treatment.

New procedure tackles the cause

"For this reason, we are increasingly recommending surgical treatment procedures at an early stage in order to achieve long-term results," explains Mario Scaglioni, who also heads the Leo Clodius Lymphatic Center, the first private lymphatic centre in Switzerland. The so-called lymphovenous anastomosis (LVA) addresses the actual cause of the problem by diverting the lymph fluid directly into the nearby veins via a newly created drainage pathway. "This allows excess lymphatic fluid, which would accumulate in the tissue and cause swelling, to flow out into the venous system," explains the plastic surgeon specialising in microsurgery.

Gentle procedure

The procedure is relatively gentle for patients as it is minimally invasive. It can significantly alleviate symptoms and slow down the progression of lymphoedema, "as well as improving quality of life". How successful the procedure is depends largely on the stage of the lymphoedema. "In the early stages, when the tissue is not yet heavily scarred and the lymph vessels are largely functional, LVA can slow down the progression of the disease. Mario Scaglioni is convinced: "LVA is a promising option in modern lymphoedema therapy, which cannot replace conservative procedures, but can complement them."

This article was published as an interview with Prof. Dr Mario Scaglioni, Head of the Leo Clodius Lymphatic Centre, in Glückspost.