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Surgeon Develops Procedure to Prevent Arm Swelling in Breast Cancer Patients

A surgeon has developed a new procedure to prevent one of the most common side effects associated with breast cancer treatment – lymphedema or swelling of the arms due to faulty drainage of the lymph nodes. //

V. Suzanne Klimberg, M.D., director of the UAMS breast cancer program, led a study of breast cancer patients at risk for developing lymphedema.

'The removal and analysis of the lymph nodes under the arm remains the most important factor in determining the severity of disease in breast cancer patients,' Klimberg said. 'In the past, surgery to remove the lymph nodes and most of the fat and tissue in the armpit often resulted in complications, including lymphedema.' Five percent to 50 percent of women undergoing surgical treatment for breast cancer have developed lymphedema, mainly dependent upon the extent of surgery.

At the ACRC, surgeons determined that the draining of the first lymph node, known as the sentinel lymph node, is capable of predicting if the cancer has spread to the remaining armpit lymph nodes, known as axillary lymph nodes. This is a less invasive surgery and reduces the likelihood of complications.

However, the lymph node system is at risk of disruption during either a sentinel lymph node biopsy or an axillary lymph node dissection, which often leads to swelling in the arm.

To prevent the arm swelling, Klimberg has developed the Axillary Reverse Mapping (ARM) procedure. The new technique evaluates the ways in which fluid drains through the lymph node system in the arm through the injection of blue dye. The dye is used to map the drainage of the arm.

'Mapping the drainage of the arm decreases the chances of unintended disruption of the lymph node system during surgery and reduces the risk of developing swelling in the arm,' Klimberg said. 'We are the first to study lymph node drainage in the arm and are now using the ARM procedure as standard procedure at UAMS.'

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