Simplified Lymphatic venous Anastomosis for the Prevention of Breast Cancer-Related Lymphedema: A Two-Patient Case Series

2026-07-27T03:42:59+00:00

Breast cancer-related lymphedema (BCRL) remains a significant complication following breast cancer treatment, particularly after axillary lymph node dissection (ALND), which can disrupt upper-extremity lymphatic drainage and substantially impair patients' quality of life. Immediate lymphatic reconstruction, including the Simplified Lymphatic Microsurgical Preventing Healing Approach (S-LYMPHA), has emerged as a promising preventive strategy to reduce the risk of BCRL. This study aimed to describe the technical feasibility, operative characteristics, and early clinical outcomes of S-LYMPHA performed immediately following ALND in patients with locally advanced breast cancer. A descriptive case series was conducted involving two women with locally advanced breast cancer who underwent modified radical mastectomy with ALND, followed immediately by S-LYMPHA at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Clinical data, surgical procedures, additional operative time, postoperative complications, and early lymphedema-related outcomes were evaluated through medical record reviews and postoperative follow-up assessments. The procedure was successfully performed by intussuscepting multiple lymphatic vessels into a single branch of the thoracodorsal vein under surgical loupe magnification. The additional operative time required was 35 minutes for the first patient and 40 minutes for the second patient. During the three- and four-month follow-up periods, respectively, neither patient demonstrated clinical evidence of upper-extremity lymphedema, significant interlimb circumference differences, or subjective symptoms of arm heaviness. Postoperative complications included seroma formation and mastectomy skin-flap necrosis, both of which were managed appropriately. In conclusion, S-LYMPHA employing a multiple-lymphatic-vessel-to-single-vein anastomosis technique is technically feasible and may represent an accessible and effective preventive approach for reducing the risk of BCRL following ALND. Nevertheless, prospective studies involving larger patient cohorts, longer follow-up durations, and objective lymphatic function assessment methods are warranted to confirm its long-term safety and effectiveness.

Challenges in Management of Malignant Phyllodes Tumor with Thoracic Wall Infiltration a Retrospective Case Series

2026-08-13T03:32:44+00:00

Malignant phyllodes tumors are rare fibroepithelial breast neoplasms with aggressive behavior, particularly when they infiltrate the thoracic wall, where achieving adequate surgical margins and timely adjuvant treatment becomes difficult. This study aimed to describe the clinical management and outcomes of patients with malignant phyllodes tumors involving the thoracic wall, focusing on surgical margin status, local recurrence, adjuvant radiotherapy, and overall clinical outcome. A retrospective descriptive case-series design was used by reviewing medical records of three patients treated at the Oncology Surgery Department, Padjadjaran University–RS Hasan Sadikin. Data included patient characteristics, surgical treatment, histopathological margin status, timing of radiotherapy, recurrence, metastasis, and clinical outcomes, which were analyzed descriptively. All patients underwent wide local excision. Only one patient achieved a tumor-free margin and remained free from local recurrence while receiving adjuvant radiotherapy, although pleural effusion suspicious for metastasis developed. The other two patients had positive margins, experienced rapid local recurrence within two to four weeks after surgery, and died before radiotherapy could be administered. These findings indicate that achieving negative surgical margins is crucial for local control, while prompt adjuvant treatment and continued systemic surveillance remain important in managing this rare and aggressive disease, especially in patients with extensive thoracic wall involvement.

Asian Journal of Healthy and Science

Simplified Lymphatic venous Anastomosis for the Prevention of Breast Cancer-Related Lymphedema: A Two-Patient Case Series

Challenges in Management of Malignant Phyllodes Tumor with Thoracic Wall Infiltration a Retrospective Case Series