Lymphovenous Bypass Surgery for Breast Cancer Treatment
Surgery is a standard and integral part of breast cancer treatment, with the vast majority of patients undergoing a lumpectomy or mastectomy to remove the cancer. During the procedure, the surgeon may also remove the axillary lymph nodes (located in the armpit) to determine whether the tumor has spread. While lymph node removal is important for understanding and managing breast cancer progression, it also disrupts the body’s ability to drain lymph fluid, leading to lymphedema in approximately 44% of patients.
Lymphedema occurs when lymph fluid builds up in tissues, leading to painful arm swelling, a sensation of heaviness and restricted movement—all of which can impact the patient’s quality of life. Lymphovenous bypass surgery is an advanced microsurgical technique aimed at preventing and treating lymphedema in breast cancer patients. During breast cancer surgery, immediately after removing the axillary lymph nodes, the surgeon will reconnect the lymphatic channels to nearby veins. The goal is to maintain normal fluid drainage, which can significantly lower the risk of lymphedema.
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Schedule an AppointmentWhat are the types of lymphovenous bypass surgery for breast cancer treatment?
Key approaches to lymphovenous bypass surgery include:
- Immediate lymphovenous bypass – Also known as supermicrosurgical lymphaticovenular anastomosis (LVA), this technique may be performed immediately after lumpectomy or mastectomy with lymph node removal to help prevent lymphedema.
- Delayed lymphovenous bypass – This standalone procedure may be performed to restore lymphatic drainage in a patient who developed lymphedema after breast cancer surgery.
- Integration with other reconstructive techniques – Lymphovenous bypass surgery can be performed alongside vascularized lymph node transfer (VLNT) and suction-assisted lipectomy (SAL). Each procedure addresses lymphedema differently, and combining them can improve the overall outcome.
Who is a good candidate for lymphovenous bypass surgery for breast cancer treatment?
Lymphovenous bypass surgery may be suitable for a patient who is:
- Undergoing breast cancer surgery that involves axillary lymph node removal
- At elevated risk for developing lymphedema
- Already experiencing lymphedema and seeking surgical options to restore lymphatic drainage
To help ensure the optimal treatment plan, the patient will undergo a personalized evaluation by a multidisciplinary team specializing in breast and reconstructive oncology.
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Request an AppointmentWhat are the potential benefits of lymphovenous bypass surgery for breast cancer treatment?
With lymphovenous bypass surgery, the patient may benefit from:
- A dramatic reduction in the risk of developing lymphedema after breast cancer surgery, from approximately 44% to as low as 7% with immediate bypass
- Reduced discomfort, such as arm swelling, fullness and tenderness, along with improved limb mobility
- Lower risk of recurrent infections, such as cellulitis, a common complication of lymphedema
- Better quality of life after breast cancer treatment due to fewer long-term complications and an improved functional outcome
How to prepare for lymphovenous bypass surgery for breast cancer treatment
Preparation for lymphovenous bypass surgery typically includes:
- A comprehensive preoperative consultation with a multispecialty team—including breast surgeons, microsurgeons and lymphedema specialists—to evaluate lymphatic function and plan the procedure
- Screening for early signs of lymphedema through bioimpedance spectroscopy (BIS) and lymphatic imaging
- Careful coordination between the surgical and anesthesiology teams to support same-day surgery or a short hospital stay in alignment with breast surgery
- Presurgical and postsurgical guidance, including skin care instructions, medication review and recommendations for compression therapy and ongoing lymphatic care
What to expect after lymphovenous bypass surgery for breast cancer treatment
After lymphovenous bypass surgery, the patient can expect:
- A recovery process coordinated with the breast surgery care plan, which may include a short hospital stay
- Periodic follow-up appointments with a multidisciplinary team, including therapy specialists, to monitor lymphatic function and limb condition
- Standard lymphedema management practices, such as compression garments, manual lymphatic drainage and physical therapy, as part of a coordinated postoperative care plan
- Continued surveillance using Lymphedema Index (L-Dex) measurements and clinical assessments to detect any early changes in lymphatic flow
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Schedule an AppointmentWhat are the risks and potential complications of lymphovenous bypass surgery for breast cancer treatment?
Like any surgery, lymphovenous bypass carries risks and potential complications, including infection, delayed wound healing and surgical failure. In some cases, the lymphatic reconnections may not fully restore fluid drainage.
The outcome of lymphovenous bypass can also vary depending on the patient’s anatomy and healing response. Working with an experienced microsurgical team and receiving comprehensive postoperative care can help reduce these risks and support the best possible result.
Benefit from world-class care at Moffitt Cancer Center
Moffitt is home to one of the nation’s premier lymphedema surgical programs. Led by pioneer Dr. Nicholas Panetta and supported by a multispecialty team with nearly a decade of expertise, our Multidisciplinary Lymphedema Clinic has performed thousands of procedures—including three to five lymphovenous bypass surgeries per week—since its founding in 2016.
If you would like to learn more about lymphovenous bypass surgery, you are welcome to talk with a breast cancer specialist in the Don & Erika Wallace Comprehensive Breast Program at Moffitt. To request an appointment, call 1-888-663-3488 or submit a new patient registration form online. We are committed to reducing the burden of lymphedema through leading-edge care that prioritizes your health and quality of life, and we do not require referrals.