ObjectivesThis study aimed to identify the cognitive factors associated with the professional healthcare advice (PHCA) seeking behavior in breast cancer‐related lymphedema (BCRL).MethodsFrom January 2018 to December 2018, patients with BCRL were prospectively enrolled for a cross‐sectional survey of lymphedema‐related perceived risks, lymphedema quality of life (LYMQoL), knowledge scale of lymphedema, and PHCA behavior at first clinical visit, 3 and 6 months postbaseline.ResultsA total of 180 patients including 100 (55.6%) patients underwent a vascularized lymph node transfer (VLNT) and 80 (44.4%) patients received compressive decongestive therapy (CDT) were enrolled. At 6 months of follow‐up, mean episodes of cellulitis (from 2.2 to 0.2 times/year), mean circumferential difference (7.8 ± 3.9%), wearing compression garments (from 29% to 0 %) in the VLNT group were statistically reduced than those in the CDT group (p = .01, <.01, and <.01, respectively). The overall LYMQoL had statistical improvement in VLNT group (p < .01). The short symptom duration, greater education level, less episodes of cellulitis, and higher knowledge of lymphedema were associated with increased adherence to PHCA (p = .03, .03, .02, and .01, respectively).ConclusionBCRL patients who sought PHCA had great control of lymphedema and improve their quality of life.

Background: Vascularized submental lymph node (VSLN) transfer is an emerging approach for extremity lymphedema. This study investigated the long‐term outcome and venous complications of VSLN for unilateral lower extremity lymphedema.Methods: Between 2010 and 2018, patients who underwent VSLN for unilateral lower extremity lymphedema were retrospectively evaluated. Patient demographics, operative records, complications, circumferential improvement, and episodes of cellulitis were analyzed. Further comparisons were performed between different types, numbers, and techniques of venous anastomoses.Results: A total of 75 VSLNs in 70 patients survived, giving a 100% success rate. Six flaps (8%) had venous complications (VC group) and 69 flaps (92%) did not (No‐VC group). There were no statistical differences in types, numbers, and techniques of anastomoses between two groups (P = .65, 1, and .56, respectively). At a mean follow‐up of 32.0 ± 23.0 months, mean circumferential improvement and episodes of cellulitis between two groups did not statistically differ significantly (P = .31 and .09, respectively).Conclusions: VSLN is an effective treatment for lower extremity lymphedema. The types, numbers of veins, and techniques of venous anastomoses did not statistically affect the venous complication rates. Functional outcomes of the VSLNs were not compromised if venous complications were salvaged promptly.

BackgroundVascularized lymph node transfer (VLNT) has become one of the effective surgical treatments for extremity lymphedema. This study was to evaluate the re‐exploration and total complication rates of VLNT for lower extremity lymphedema between two different flap inset techniques.MethodsSixty‐nine patients who underwent 74 submental VLNT transfers between 2008 and 2018 were retrospectively studied. Fifty‐six flaps were inset using a new delayed primary retention suture (DPRS) technique and other 18 flaps using conventional interrupted sutures as the non‐DPRS group.ResultsThe overall flap success rate was 100%. The DPRS group was released at a mean of 1.7  ± 0.7 times and took a mean of 10.3 ± 3.3 days for wound closure. There were no statistical differences in demographics, mean symptom duration, and mean Cheng's Lymphedema Grading between two groups. Mean frequency of cellulitis of 2.5 ± 1.5 times/year in non‐DPRS group was significantly greater than 1.4 ± 1.6 times/year in DPRS group (P = .01). The re‐exploration and total complication rates were 5.4% and 7.1% in DPRS group, and 27.8% and 33.3% in non‐DPRS group, respectively (P = .02 and .02, respectively).ConclusionsThe DPRS technique is a safe, simple, and reliable method for insetting the submental VLNT, which statistically decreased the re‐exploration and total complication rates.