Sheldon Feldman, MD, chief, Breast Surgical procedure and Breast Surgical Oncology, professor, Division of Surgical procedure, director, Breast Most cancers Providers, at Montefiore Einstein Complete Most cancers Middle, discusses new approaches for lowering the chance of and managing breast most cancers–associated lymphedema.
Feldman explains that being aware of which sufferers require surgical procedure of the axilla will help scale back the chance of lymphedema within the breast most cancers inhabitants. He emphasizes that advances within the understanding of tumor biology and axillary imaging, resembling ultrasound, have allowed for extra correct evaluation of mandatory therapies, together with whether or not the axilla must be eliminated. This strategy considerably reduces the chance of lymphedema, since avoiding surgical procedure on lymph nodes totally eliminates this threat, he says.
For sufferers who do want axillary surgical procedure, Feldman notes that it’s essential for surgeons to have a radical understanding of axillary anatomy. Medical training sometimes covers the anatomy, however sensible software requires recognizing that axillary lymph nodes drain each the breast and the arm, he says. Lymphedema happens when the lymphatic drainage of the arm is disrupted through the removing of lymph nodes.
To mitigate this, Feldman means that surgeons determine and protect lymph nodes that particularly drain the arm throughout breast most cancers surgical procedure. Feldman explains that “smarter axillary surgical procedure” can considerably scale back the incidence of lymphedema.
Lowering the chance of lymphedema in sufferers with breast most cancers entails a extra selective strategy to axillary surgical procedure, leveraging tumor biology, and utilizing superior imaging to keep away from pointless lymph node removing, he continues. Exploring extra conservative remedy strategies might characterize a shift in the direction of extra knowledgeable and anatomically exact surgical methods, Feldman concludes.
