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Liposuction of Breast Cancer: Related Arm Lymphedema Reduces Fat and Muscle Hypertrophy

Karlsson, Tobias LU orcid ; Karlsson, Magnus LU ; Ohlin, Karin ; Olsson, Gaby and Brorson, Håkan LU orcid (2022) In Lymphatic Research and Biology 20(1). p.53-63
Abstract

Introduction: Adipose tissue deposition is a known consequence of lymphedema. A previous study showed that the affected arm in patients with nonpitting breast cancer-related lymphedema (BCRL) had a mean excess volume of 73% fat and 47% muscle. This condition impairs combined physiotherapy as well as more advanced microsurgical methods. Liposuction is, therefore, a way of improving the effects of treatment. Objective: This study aims to evaluate the tissue changes in lymphedematous arms after liposuction and controlled compression therapy (CCT) in patients with nonpitting BCRL. Methods and Results: Eighteen women with an age of 61 years and a duration of arm lymphedema (BCRL) of 9 years were treated with liposuction and CCT. Tissue... (More)

Introduction: Adipose tissue deposition is a known consequence of lymphedema. A previous study showed that the affected arm in patients with nonpitting breast cancer-related lymphedema (BCRL) had a mean excess volume of 73% fat and 47% muscle. This condition impairs combined physiotherapy as well as more advanced microsurgical methods. Liposuction is, therefore, a way of improving the effects of treatment. Objective: This study aims to evaluate the tissue changes in lymphedematous arms after liposuction and controlled compression therapy (CCT) in patients with nonpitting BCRL. Methods and Results: Eighteen women with an age of 61 years and a duration of arm lymphedema (BCRL) of 9 years were treated with liposuction and CCT. Tissue composition of fat, lean (muscle), and bone mineral was analyzed through dual energy X-ray absorptiometry (DXA) before, and at 3 and 12 months after surgery. Excess volumes were also measured with plethysmography. The median DXA preoperative excess volume was 1425 mL (704 mL fat volume, 651 mL lean volume). The DXA excess volume at 3 months after surgery was 193 mL (-196 mL fat volume, 362 mL lean volume). At 12 months after surgery, the median excess DXA volume was 2 mL (-269 mL fat volume, 338 mL lean volume). From before surgery to 3 months after surgery, the median DXA excess volume reduced by 85% (p < 0.001) (fat volume reduction 128% (p < 0.001), lean volume reduction 37% (p = 0.016)). From before surgery to 12 months after surgery, it reduced by 100% (p < 0.001) (fat volume reduction 139% [p < 0.001], lean volume reduction 54% [p = 0.0013]). Conclusions: Liposuction and CCT effectively remove the excess fat in patients with nonpitting BCRL, and a total reduction of excess arm volume is achievable. A postoperative decrease in excess muscle volume is also seen, probably due to the reduced weight of the arm postoperatively.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Lymphatic Research and Biology
volume
20
issue
1
pages
53 - 63
publisher
Mary Ann Liebert, Inc.
external identifiers
  • pmid:33656374
  • scopus:85125552757
ISSN
1539-6851
DOI
10.1089/lrb.2020.0120
language
English
LU publication?
yes
id
1d4d3f8d-158c-4e9b-aa2b-eea8181edb4f
date added to LUP
2021-08-10 10:22:39
date last changed
2024-07-11 12:06:06
@article{1d4d3f8d-158c-4e9b-aa2b-eea8181edb4f,
  abstract     = {{<p>Introduction: Adipose tissue deposition is a known consequence of lymphedema. A previous study showed that the affected arm in patients with nonpitting breast cancer-related lymphedema (BCRL) had a mean excess volume of 73% fat and 47% muscle. This condition impairs combined physiotherapy as well as more advanced microsurgical methods. Liposuction is, therefore, a way of improving the effects of treatment. Objective: This study aims to evaluate the tissue changes in lymphedematous arms after liposuction and controlled compression therapy (CCT) in patients with nonpitting BCRL. Methods and Results: Eighteen women with an age of 61 years and a duration of arm lymphedema (BCRL) of 9 years were treated with liposuction and CCT. Tissue composition of fat, lean (muscle), and bone mineral was analyzed through dual energy X-ray absorptiometry (DXA) before, and at 3 and 12 months after surgery. Excess volumes were also measured with plethysmography. The median DXA preoperative excess volume was 1425 mL (704 mL fat volume, 651 mL lean volume). The DXA excess volume at 3 months after surgery was 193 mL (-196 mL fat volume, 362 mL lean volume). At 12 months after surgery, the median excess DXA volume was 2 mL (-269 mL fat volume, 338 mL lean volume). From before surgery to 3 months after surgery, the median DXA excess volume reduced by 85% (p &lt; 0.001) (fat volume reduction 128% (p &lt; 0.001), lean volume reduction 37% (p = 0.016)). From before surgery to 12 months after surgery, it reduced by 100% (p &lt; 0.001) (fat volume reduction 139% [p &lt; 0.001], lean volume reduction 54% [p = 0.0013]). Conclusions: Liposuction and CCT effectively remove the excess fat in patients with nonpitting BCRL, and a total reduction of excess arm volume is achievable. A postoperative decrease in excess muscle volume is also seen, probably due to the reduced weight of the arm postoperatively.</p>}},
  author       = {{Karlsson, Tobias and Karlsson, Magnus and Ohlin, Karin and Olsson, Gaby and Brorson, Håkan}},
  issn         = {{1539-6851}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{53--63}},
  publisher    = {{Mary Ann Liebert, Inc.}},
  series       = {{Lymphatic Research and Biology}},
  title        = {{Liposuction of Breast Cancer: Related Arm Lymphedema Reduces Fat and Muscle Hypertrophy}},
  url          = {{http://dx.doi.org/10.1089/lrb.2020.0120}},
  doi          = {{10.1089/lrb.2020.0120}},
  volume       = {{20}},
  year         = {{2022}},
}