{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T10:33:05Z","timestamp":1793529185310,"version":"4.5.0"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer-related lymphedema (BCRL) significantly affects quality-of-life after axillary lymph node dissection (ALND). Although immediate lymphatic reconstruction (ILR) may reduce BCRL incidence, its long-term outcomes and predictors remain unclear. We report long-term BCRL prevalence in patients undergoing ILR and delineate factors associated with BCRL after ILR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied consecutive patients who underwent ILR following ALND between 2017 and 2024 across six hospitals in the Indiana University network. Primary outcome was BCRL prevalence, defined as \u2265\u20092-cm limb difference at two contiguous points. Secondary outcomes included BCRL predictors, postoperative complications, and compression garment use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 172 patients with a mean age 50.9\u2009\u00b1\u200911.6\u00a0years, body mass index of 29.5\u2009\u00b1\u20096.9\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and follow-up time of 23.1\u2009\u00b1\u200915.2 months. Most patients (57.7%) underwent mastectomy, ALND with breast reconstruction. The median number of lymph nodes removed during ALND was 15 (interquartile range [IQR] 10.0\u201321.0), and median number of positive lymph nodes was 2.0 (IQR, 0.0\u20134.0). The cumulative BCRL incidence was 7.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912 patients). Median time to significant limb swelling was 4.5 (IQR, 1.0\u201311.3) months. Fifty-five patients (32.0%) used postoperative compression garments. Breast-related complications occurred in 30.2% of patients. Black\/African American patients had significantly higher lymphedema rates than White patients (18.8% vs. 4.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). In adjusted analyses, Black\/African American race was an independent predictor (odds ratio [OR], 6.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.006) of BCRL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immediate lymphatic reconstruction following ALND demonstrated low BCRL rates, although Black or African American patients remain at disproportionately higher risk, warranting targeted interventions and further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-025-17301-0","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T10:45:24Z","timestamp":1744800324000},"page":"5817-5826","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Long-Term Outcomes of Lymphedema After Immediate Lymphatic Reconstruction Following Axillary Lymph Node Dissection"],"prefix":"10.1245","volume":"32","author":[{"given":"Abbas M.","family":"Hassan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Hajj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahnur","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla S.","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kandice K.","family":"Ludwig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Danforth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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