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Topic: lymphovenous bypass surgery

Forum: Lymphedema —

Talk with other about how to lower your risk of lymphedema and how to manage it if you've been diagnosed.

Posted on: Nov 24, 2021 10:46AM

trose348 wrote:

New to everything! Just diagnosed this yr. w/ breast cancer. They said stage 1, now it's stage 3. I had the lumpectomy Oct. 26th & 5 lymph nodes were removed. All 5 positive. They are now doing a lymphovenous bypass surgery to remove more lymph nodes to test them. I have been trying to find out as much as possible about this & seems difficult to find answers. I have the plastic surgeon's appt. Nov. 30th. I would like to know is this an out patient procedure? If so, how many do they remove & what is the recovery time? How large are the cuts. This would be on my left side. How far down do they go? Is it full anesthesia? I had a PET scan & it's negative, but guess they can't see the lymph's w/ this???? TY ahead of time.

Dx 6/24/2021, IDC, Left, Stage IIIA, Grade 2, 5/5 nodes, ER+/PR+, HER2-
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Nov 24, 2021 02:10PM brittonkb wrote:

Are you having the lymphovenous bypass in conjunction with an axillary lymph node dissection? I had a similar situation. They thought no nodes but after lumpectomy learned that 3 of 4 nodes taken were positive.

I had an axillary lymph node dissection (ALND) where they opened me back up (near arm pit) and removed my level 1 and 2 lymph nodes. That procedure was done by my breast surgeon and was under full anesthesia. She used my previous incision where they took my sentinel nodes to open me back up.

Then a plastic surgeon performed the lymphovenous bypass while I was already opened up for the ALND. The purpose of the bypass is to reduce the risk of developing lymphedema. He put a dye in to see where the lymphatic channels may have been cut and then performed the bypass on those. I only had one such channel that was bypassed. My surgeon indicated that 1-2 is the norm but that it could be more.

My surgeons said I could go home that same day (this was in July 2020 at the height of Covid) but I opted to stay the night at the hospital because I live 2 hours away. I can't recall the exact time for recovery but I know I had the surgery 7/6 and I went on a trip with my family on 7/18. I was sore but it wasn't too bad. I did have a drain that came out before my trip.

Dx 4/29/2020, IDC, Right, 4cm, Stage IIB, Grade 3, 3/13 nodes, ER+/PR+, HER2- (IHC) Surgery 5/20/2020 Lumpectomy; Lymph node removal: Sentinel Surgery 7/6/2020 Lymph node removal: Underarm/Axillary Chemotherapy 8/3/2020 AC + T (Taxol) Radiation Therapy 1/20/2021 Whole-breast: Breast, Lymph nodes Hormonal Therapy 3/24/2021 Arimidex (anastrozole) Surgery 4/23/2021 Prophylactic ovary removal
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Nov 24, 2021 03:33PM trose348 wrote:

I do not know about the axillary lymph node dissection????? I am guessing this is biopsy? All I know is I was told by my surgeon that if 5 out of 5 come back positive, I have to have more removed in the area where the breast cancer was. I do not want to stay overnight in the hospital. Did they find more positive lymph nodes on you? Do you remember how long this surgery was, from the time you arrived til they were done? Were you able to move your arm ok right after the surgery? How much pain did you experience? Thank you :)

Dx 6/24/2021, IDC, Left, Stage IIIA, Grade 2, 5/5 nodes, ER+/PR+, HER2-
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Nov 24, 2021 07:39PM MinusTwo wrote:

trose: Below is a link to read about lymphovenous bypass surgery. I don't think this surgery is done just to remove & test lymph nodes.

https://www.mskcc.org/cancer-care/patient-educatio...

Maybe you mean an Auxiliary Lymph Node Dissection?

I had an ALND after a lymph node turned up positive after biopsy. The surgery was a couple of hours. No they did not find any more positive nodes. I stayed overnight in the hospital because I don't react well to anesthesia. No - you should not move your arm. Your doc will give you a timeline but exercise is usually introduced gradually - so probably no lifting at all on that side. Of course, all docs are different so you should ask your doc for his recommendations.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Nov 25, 2021 08:01AM trose348 wrote:

I do not have lymphedema, as of yet. I was told I had to have more lymph nodes removed because the 5 out of 5 lymph nodes they removed in surgery (my lumpectomy) were positive. They want to see if anymore lymph nodes have cancer, even though the PET scan came back negative. I will know more on the 30th, but the link you gave is the same info. I have been finding also. I think they're making sure that the patients do not get lymphedema these days & it's a newer surgery they are doing. I will let you know after the 30th. TY :)

Dx 6/24/2021, IDC, Left, Stage IIIA, Grade 2, 5/5 nodes, ER+/PR+, HER2-
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Nov 25, 2021 01:10PM LW422 wrote:

Trose--what Minus 2 was explaining is that in your original post you indicated the surgeon is doing the bypass surgery "to remove lymph nodes to test them." A lymphovenous bypass is not a surgery to remove nodes but is a microscopic procedure to connect cut lymph channels to blood vessels. You may be having the bypass in addition to the node dissection, however.

There are several threads on the Lymphovenous Bypass procedure on the forum so you might do a search and read them. I had the bypass done during a mastectomy/ALND last August. The bypass was done using the same surgical opening as the ALND; no additional wound. It's hard to say how many nodes will be removed; that depends on your anatomy and your surgeon. Good luck.

Dx 1/20/2021, IDC/IBC, Right, Stage IIIB, Grade 3, 0/32 nodes, ER-/PR+, HER2- Chemotherapy 2/7/2021 AC + T (Taxol) Surgery 8/23/2021 Lymph node removal: Right; Mastectomy: Right Radiation Therapy 10/4/2021
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Nov 25, 2021 01:12PM trose348 wrote:

Yes, I do lots of research & then just comes to the point where I rather ask the question. TY

Dx 6/24/2021, IDC, Left, Stage IIIA, Grade 2, 5/5 nodes, ER+/PR+, HER2-
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7 hours ago trose348 wrote:

Had my consult w/ the plastic surgeon. The reason why I couldn't find any info. about this particular type of surgery they are doing is because it's brand new, state of the art....according to the Dr. I found 1 video on You Tube that basically sums it up. 1 Dr. will remove more lymph nodes & check those for cancer. The plastic surgeon will re-attach the lymphatic veins so that I do not get lymphedema. Basically, this type of procedure is to alleviate the possiblility of my getting lymphedima. It was a fascinating conversation. I am very happy to be part of Orlando Health & this new procedure. The Dr. said they call it this name because they do not have a new name yet for this procedure. Here is the link I found on You Tube that shows & explains it well. https://www.youtube.com/watch?v=lcqAsmmzc_c

Dx 6/24/2021, IDC, Left, Stage IIIA, Grade 2, 5/5 nodes, ER+/PR+, HER2-
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5 hours ago SpecialK wrote:

trose - both procedures - Axillary Lymph Node Dissection (ALND) and Lymphovenous Bypass (LVA ) - have been around for quite a while, the "new" part is doing the bypass as a preventive measure rather than waiting to see if you develop lymphedema at some point after the axillary dissection. You are indeed fortunate to be at a center that offers this, although Orlando Health has been doing this type of microvascular surgery since 2013. There is a lengthy thread on this site with patients who have had the bypass surgery after developing lymphedema and the bypass was done to treat it. I will link it below. I have had the work-up for bypass at Moffitt Cancer Center here in Tampa but have not yet elected to have it - my lymphedema is currently well controlled enough that I am unwilling to have surgery for it. In those with confirmed diagnosed lymphedema this surgery does not guarantee success - hoping the preventive works well and becomes commonplace.

https://community.breastcancer.org/forum/64/topics/818062?page=23#post_5717072

Some background on this type of surgery, this is the doc mentioned in the above thread a lot and who is considered to be a pioneer for this in the US -

https://consultqd.clevelandclinic.org/supermicrosurgery-for-the-treatment-of-lymphedema/

https://www.youtube.com/watch?v=7zUHLoy8APc

BMX w/ TE 11/1/10, ALND 12/6/10. 16 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 2013-2018. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)

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