Microsurgery
developing. Traditionally, breast cancer travels to the armpits and if lymph nodes are removed, this treats the cancer but prevents drainage from the arm and so fluid starts to build up. “We have now carried out immediate lymphatic reconstruction (ILR) on a large number of patients in our unit, however sometimes the lymphatics in the arm can be far from the veins in the body. Here we used a new but difficult technique where we essentially take a length of vein often from the abdomen and use the graft to connect it directly to the lymphatic and then to a vein in the body, allowing restoration of drainage. We believe that preventative or prophylactic lymphatic reconstruction at this point in the patient’s journey could reduce breast cancer related lymphoedema down to 4% to 8% (from 20-30%) based on current data worldwide.” As lymphoedema is difficult to treat, it may worsen with age which means more treatments and more of a drain on public health resources. In fact, according to Ms Laura Puscas, Consultant Plastic Surgeon and co-author of the study, statistics show that the problem is becoming more acute each year. She explains: “In general, we are seeing younger people, sometimes patients in their 20s to 30s presenting with breast cancer. At this age range, the cancer is more aggressive. “Lymphoedema patients face enormous
physical, psychological and socioeconomic consequences. The condition can be not only painful, but disfiguring and lead to a loss of mobility, independence, reduced productivity, and depression. With no cure, treatment for the condition is largely palliative and requires meticulous daily management.” The second study, ‘Outcomes of Axillary
health care professionals. Our study identified, by limb volume increase, that after ALND the highest rates of lymphoedema were observed in smokers, those with class 2 obesity, patients over 70 and those receiving radiotherapy. With this precise knowledge we are now able to inform regarding best treatment policy to improve long-term outcomes.” Consultant plastic surgeon and BAPRAS
President Paul McArthur commented: “It is always encouraging to see the latest advances being presented to the surgical community at our Scientific Meetings. For too long lymphoedema treatment has been difficult to access once it develops, with very few options and a post-code lottery for whether surgery is even available. The option for prophylactic treatment before or during node removal is promising to prevent patients from future unnecessary suffering.”
Emily Maynard has fully recovered after treatment in Broomfield Hospital
Surgery-Related Lymphoedema: Identifying Predictors for Exclusion from Prophylactic Lymphatic-Venous Anastomosis,’ set out to identify those patients most likely to benefit from additional treatment following axillary lymph node dissection (ALND) based around age, BMI, smoking status, tumour characteristics, and radiotherapy. According to co-study author, Joanna
Ochogwu from Cambridge University Hospital: “Lymphoedema is a life-long condition but ‘nipping it in the bud’ and making the right decisions earlier at treatment stage means that it is much more likely that individuals will be able to manage their own condition with minimal intervention or dependence on
Case study A mother of two who received the devastating diagnosis of breast cancer at the age of just 29 has embraced her experiences to help raise awareness by sharing essential knowledge for younger cancer patients and outline the possibilities of lymphoedema post-surgery. Emily Maynard, a teaching assistant from
Essex, now 31 and fully recovered after treatment in Broomfield Hospital, discovered a lump that she thought was only a cyst when she was breastfeeding her second child. She was given a non-urgent referral where she was reassured that everything seemed normal. Little did she know that her world and family life was about to be turned upside-down. Emily explains: “Everybody at the clinic was
very optimistic at first so when I was called back, my diagnosis was a total shock. I thought, I’m just too young to have breast cancer. I went from stage 1A to 3A overnight and was told that the cancer was in my lymph nodes. They booked me in for a mastectomy, axillary lymph node removal and breast reconstruction using my tummy tissue (DIEP flap). Beforehand, I had to have 8 shots of chemotherapy. “I must have been the youngest person in
the clinic by 30 years. Everyone was lovely but I felt very isolated. I burst into tears and I was really scared. I hadn’t had any medical problems before, so it was all too much. I thought, how am I going to explain what’s going on to my family? How are we going to parent our children through this?” Before surgery, Emilly attended a Breast
Reconstruction Awareness (BRA) meeting at Broomfield Hospital, which are open to any women who are due to have or considering breast reconstruction. They are also attended by women who have had breast reconstruction and
July 2026 I
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