The Stitch

Innovative surgical procedure reduces risk of lymphedema for breast cancer patients

Dr. Pabel Miah

Lymphedema, a chronic and often debilitating condition, can significantly affect breast cancer patients who undergo surgery. Characterized by painful swelling, it occurs when lymphatic fluid builds up due to damaged or removed lymph nodes. However, thanks to a pioneering surgical technique, there is now a way to reduce the risk of patients developing lymphedema. This new procedure, introduced at major institutions in recent years and performed by Dr. Pabel Miah, Baylor Medicine breast surgeon, offers hope for improved postsurgical outcomes.

This innovative procedure is performed prophylactically (preventively) to reduce the likelihood of lymphedema. “By mapping out the lymphatic channels and creating a new drainage pathway through the veins, we can effectively prevent the accumulation of lymphatic fluid in the arm,” said Miah, assistant professor of surgery in the Division of Surgical Oncology. “The technique involves suturing lymphatic channels to nearby veins, allowing the lymphatic fluid to drain directly into the veins, which act as the new drainage system for the arm.”

When is this procedure performed?

The procedure is typically done at the same time as an axillary dissection, which is the surgical removal of the majority of lymph nodes from the underarm area. Patients requiring a full axillary dissection as part of their breast cancer treatment are eligible for this procedure.

Once lymphedema develops, it is notoriously hard to manage. Despite ongoing research into experimental treatments for the condition, the focus has shifted toward prevention. “The best approach is to prevent it from happening in the first place,” Miah said. “This prophylactic procedure adds only about 40 minutes to the surgical time but offers long-term benefits in reducing the risk of lymphedema and its associated complications.”

Proven results and growing adoption

Though this technique has been developed within the last few years, it is already being adopted by breast surgical oncologists at prestigious institutions such as New York University, Brown University, the Mayo Clinic and now Baylor Medicine.

“The results have been very encouraging,” Miah said. “In patients followed for several years after surgery, we have seen a significant reduction in lymphedema, which greatly improves their quality of life.”

Miah sees patients in The Woodlands and prospective patients can make an appointment by calling 713-798-7717.

By Tiffany Harston, senior communications associate in the Michael E. DeBakey Department of Surgery

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