Surgical treatment of breast cancer-related lymphedema: an updated review

Maciel-Miranda A.; Jasso-García K.; Montag E.; Ciudad P.; Escrivá-Machado J.; Pereira N. · Cirugia y Cirujanos (2025) · DOI: 10.24875/ciru.25000180

Resumen

Breast cancer-related lymphedema is a common complication after axillary lymph node dissection and radiotherapy, significantly affecting patients’ quality of life. This review aims to outline the latest surgical advances for his management, highlighting current techniques and their role in prevention and treatment at various stages of the disease. An extensive literature review was performed in major databases (PubMed, Scopus, Web of Science), focusing on original studies, systematic reviews, and metaanalyses addressing surgical techniques for the management of breast cancer-related lymphedema. Articles published in the last 10 years were included. Several surgical approaches are described, including lymphaticovenous anastomosis, vascularized lymph node transfer, immediate lymphatic reconstruction, and liposuction. The choice of procedure depends on the clinical stage of lymphedema, the availability of expertise and micro-surgical equipment. Current evidence shows that early surgical management can reduce disease progression, improve quality of life, and lower the incidence of infectious episodes. Lymphatic surgery offers promising outcomes in both prevention and treatment of breast cancer-related lymphedema. Although significant advances —such as supermicrosurgery and immediate prophylactic procedures— have been made, there is still a need for randomized clinical trials to strengthen clinical recommendations. An interdisciplinary approach and careful patient selection are critical to optimizing outcomes.