Supermicrosurgical Lymphaticovenular Anastomosis for a Breast Lymphedema Secondary to vascularized Axillary Lymph Node Flap Transfer.

Breast lymphedema (BLE) can occur after breast cancer treatments, but there have been no cases of BLE secondary to lymph node transfer (LNT) using an axillary lymph node (ALN). We report the first case of LNT-related BLE successfully treated with supermicrosurgical lymphaticovenular anastomosis (LVA). A 50-year-old female presented with left BLE after LNT harvesting from the left axilla for the treatment of secondary lower extremity lymphedema in another hospital. Although the left breast did not seem edematous, the patient suffered from sensation of tension and frequent episodes of left breast cellulitis. Since conservative treatments were not effective, LVA was performed at the lateral thoracic region. A 0.5 mm lymphatic vessel was found and anastomosed to a nearby 0.35 mm vein in an intima-to-intima coaptation manner. After the LVA, the patient experienced no sensation of tension or further cellulitis attacks. Although rarely encountered, BLE can occur after axillary LNT, and LVA may be a useful therapeutic option.