Lymph node transfer is a relatively new procedure that is proving to be very successful in the management of lymphoedema as a result of surgical removal of lymph nodes during breast cancer treatment. The lymph nodes can be taken as an isolated flap of tissue in patients who do not require a breast reconstruction – normally patients who have had a wide local excision only or who have already had a breast reconstruction. If patients have not had a breast reconstruction then they may be best suited to a combined lymph node transfer and DIEP breast reconstruction. It was originally described by French surgeon Dr Becker and has shown to be of great benefit to patients plagued by lymphoedema. I am one of the few surgeons in Europe offering this technique and have had very promising results with several years follow up.
The procedure involves harvesting several superficial lymph nodes from the groin area. The superficial lymph nodes are not responsible for draining the leg and therefore it is unlikely that you would develop lymphoedema of your leg.
The lymphoedema begins to improve rapidly and most patients will notice a reduction in the size of their affected limb before discharge from the hospital. However the limb will continue to soften and reduce over the following 18 months. The lymph nodes have been shown to release cytokines (cell signalling chemicals) that encourage old lymphatic pathways to open up and new networks to develop. Most patients will notice reduced discomfort and heaviness in their affected limb that starts to improve immediately. Those suffering from recurrent cellulitis also notice a dramatic reduction in the number of episodes. Depending on the severity and length of time you have had lymphoedema, you may need subsequent procedures such as a further lymph node transfer to the elbow, liposuction or lymphatic venous anastomosis. It is essential to continue to wear your lymphoedema garments and be managed by a lymphoedema nurse as you recover. We have our own lymphoedema nurse who will look after you throughout your time with us. She will liaise with your local team following your discharge.