Breast cancer is the most common type of cancer among women, with an estimated 2.3
million new cases diagnosed worldwide in 2020, with especially high incidence in
developed countries. The five-year survival rate for breast cancer exceeds 90%, and the
average ten-year survival rate for women with non-metastatic invasive breast cancer is
84% (Ferlay et al., 2021).
As a consequence, there is an increasing number of women facing early and late side
effects from breast cancer treatment. One of the most common side effects is lymphedema,
with a reported incidence after cancer treatment around 30% (Martínez Jaimez, 2017). In
Colombia, it is estimated that 28% of women who undergo lymphadenectomy develop
lymphedema (Valencia Legarda et al., 2020). Lymphedema is a chronic inflammatory disease
that affects approximately 250 million people worldwide, mostly associated with cancer
treatment. It can occur as a result of breast cancer surgery and/or radiotherapy
(Riady-Aleuy et al., 2022). Lymphedema is defined as the accumulation of protein-rich
fluid in the interstitium, secondary to abnormalities in the lymphatic transport system.
According to the impact of lymphedema on the quality of life of individuals, as well as
the associated social and economic costs, efforts must be made to prevent and treat it.
Various conservative strategies are used to reduce the risk of developing lymphedema and
to manage it once it has developed. Among the physiotherapeutic options is complex
decongestive therapy (CDT), which is a conservative treatment that includes manual
lymphatic drainage (MLD), compression therapy (consisting of compression bandages,
compression sleeves, or other types of compression garments), skin care, and
lymph-reducing exercises (LRE).
Another treatment option is surgery, which has traditionally been considered a last
resort when conservative measures have failed. However, increasingly advanced surgical
interventions are now being performed early in the disease process, with the hope of
preventing or reversing edema that arises from impaired lymphatic flow (Markkula et al.,
2019). These interventions include liposuction, lymph node transfer, and
lymphaticovenular anastomosis (LVA). The latter was first described in 1960, but it
wasn't until 1989 in Japan and in 2020 in Colombia that it became the gold standard of
microsurgery, emerging as an innovative technique in our field, increasingly used as a
treatment for lymphedema rather than as a last-resort strategy when other treatments have
failed (Gupta et al., 2021).
