Lymphedema Treatments

Lymphedema affects approximately one in five breast cancer survivors, with incidence rates as high as 30% to 60% reported in survivors who have undergone axillary lymph node dissection.

Breast and lymphatic anatomy

How Is Lymphedema Treated?

The most common treatment for lymphedema is complete decongestive therapy. At City of Hope, a certified lymphedema therapist first evaluates you to create a comprehensive treatment plan that may include skin care, massage, exercise, bandaging, compression garments and presurgery evaluation, involving specialized imaging that allows your surgeon to visualize precisely the affected tissues using ICG fluorescent dye technology.

The City of Hope Difference

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City of Hope is designated as a Comprehensive Cancer Center of Excellence by the Lymphatic Education & Research Network, making it one of only four cancer centers nationwide with this prestigious recognition. City of Hope offers conventional lymphedema therapies and is among the few centers in the United States offering microsurgery treatment for lymphedema. Thanks to rapid advances in technology that allow imaging of tiny lymphatic vessels, as well as microscopes and instruments that make it possible to see and operate on the structures of the lymphatic system, several microsurgery techniques are now available to patients who fall within specific criteria.

What Lymphedema Doctors Will I See at My Appointment?

At City of Hope’s multidisciplinary lymphedema program, certified therapists work with our world-renowned plastic surgeons, oncologists, interventional radiologists and nurses. They combine expertise with the latest research and technology to provide the most effective treatment. The team will provide a thorough evaluation before and after the procedure to monitor your improvement and provide follow-up care. Meet the lymphedema team.

Surgery for Lymphedema

While many patients see improvement, every experience will be unique. Although the surgery is not a cure, it can reduce complications and severity, such as the condition's progression, pain, heaviness, infection, or reversal of changes within the affected limb. While in rare cases, treatment eliminates lymphedema, most patients require long-term care and management by the City of Hope team.

Lymphaticovenous Bypass (LVA)

This procedure redirects the lymph fluid to small veins. This is an outpatient procedure that takes between four to six hours and results in virtually no blood loss. Patients typically remain for less than 24 hours for observation.

City of Hope reconstructive plastic surgeons have extensive experience in LYMPHA (Lymphatic Microsurgical Prophylactic Healing Approach), a lymphatic reconstruction and bypass technique that reduces lymphedema risk. In LYMPHA, afferent lymphatics disrupted by lymphadenectomy are identified and anastomosed to veins, restoring lymph flow from the arm. The lymph normally flows into the blood circulation via the thoracic duct and into the subclavian vein; the LYMPHA procedure essentially creates an earlier drainage site.

Vascularized Lymph Node Transfers

A surgical procedure that transplants lymph nodes from elsewhere in your body to replace those removed during cancer treatment.

Post-Surgical Therapy or Rehabilitation

As with any surgery, there are risks like infection. Your care team will review and answer any questions you may have beforehand. You may have to minimize activities or movement after surgery, as there is usually some pain and permanent scarring in the treatment area. We also recommend you continue your prescribed care plan, e.g., wearing compression garments, massage and exercise and skincare to achieve the best outcomes.