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Case Report

Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report

  • Authors:
    • Kamil Szemik
    • Karolina Pańczyk
    • Klaudia Jurkowska
    • Weronika Bulska‑Będkowska
    • Aureliusz Kolonko
    • Jerzy Chudek
  • View Affiliations / Copyright

    Affiliations: Student's Research Group, Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40‑027 Katowice, Poland, Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40‑027 Katowice, Poland, Department of Nephrology, Transplantation and Internal Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40‑027 Katowice, Poland
  • Article Number: 420
    |
    Published online on: July 2, 2025
       https://doi.org/10.3892/ol.2025.15166
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Abstract

Upper limb lymphedema (LE) may occur following radical treatment of breast cancer (BC), and may manifest more severely in patients with dialysis vascular access located on the ipsilateral limb. The present study reports a case of a 44‑year-old female patient with patent arteriovenous fistula (AVF) in the left antecubital fossa following a third kidney transplant and the diagnosis of luminal B‑like (human epidermal growth factor receptor 2‑positive) BC of the left breast (clinical stage cT4bN2aM0), admitted to the Clinical Hospital of the Medical University of Silesia in Katowice (Poland) in October 2020. The patient received neoadjuvant systemic therapy, achieving partial regression of the tumor. Before a left‑sided mastectomy with axillary lymph node dissection (ALND), the AVF was ligated. Following radiotherapy, trastuzumab treatment was continued for 18 cycles, along with hormonal therapy, and no upper limb LE developed. After 18 months, numerous metastases of the same biological subtype appeared in the area of the previously irradiated mastectomy scar. Palliative treatment was implemented and resulted in a complete objective response. First‑line systemic treatment resulted in a partial response and disease control for 9 months. As of March 2025, the kidney graft function was stable (estimated glomerular filtration rate, 56.9 ml/min/1.73 m2) and second‑line treatment with trastuzumab emtansine was terminated after 3 months due to symptomatic brain metastases. The upfront ligation of AVF located in the antecubital fossa decreased the risk of upper limb LE, which may occur during BC treatment, ALND and chest wall and axillary region radiotherapy.
View Figures

Figure 1

Ultrasound imaging and computed
tomography of chest wall skin recurrence of breast cancer. Local
recurrence of breast carcinoma (arrow) in the area of the
mastectomy scar of the chest wall in (A) ultrasound imaging with 11
MHz linear probe and (B) contrast-enhanced computed tomography scan
of the chest.

Figure 2

Flowchart of the systemic literature
review.
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Copy and paste a formatted citation
Spandidos Publications style
Szemik K, Pańczyk K, Jurkowska K, Bulska‑Będkowska W, Kolonko A and Chudek J: Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report. Oncol Lett 30: 420, 2025.
APA
Szemik, K., Pańczyk, K., Jurkowska, K., Bulska‑Będkowska, W., Kolonko, A., & Chudek, J. (2025). Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report. Oncology Letters, 30, 420. https://doi.org/10.3892/ol.2025.15166
MLA
Szemik, K., Pańczyk, K., Jurkowska, K., Bulska‑Będkowska, W., Kolonko, A., Chudek, J."Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report". Oncology Letters 30.3 (2025): 420.
Chicago
Szemik, K., Pańczyk, K., Jurkowska, K., Bulska‑Będkowska, W., Kolonko, A., Chudek, J."Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report". Oncology Letters 30, no. 3 (2025): 420. https://doi.org/10.3892/ol.2025.15166
Copy and paste a formatted citation
x
Spandidos Publications style
Szemik K, Pańczyk K, Jurkowska K, Bulska‑Będkowska W, Kolonko A and Chudek J: Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report. Oncol Lett 30: 420, 2025.
APA
Szemik, K., Pańczyk, K., Jurkowska, K., Bulska‑Będkowska, W., Kolonko, A., & Chudek, J. (2025). Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report. Oncology Letters, 30, 420. https://doi.org/10.3892/ol.2025.15166
MLA
Szemik, K., Pańczyk, K., Jurkowska, K., Bulska‑Będkowska, W., Kolonko, A., Chudek, J."Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report". Oncology Letters 30.3 (2025): 420.
Chicago
Szemik, K., Pańczyk, K., Jurkowska, K., Bulska‑Będkowska, W., Kolonko, A., Chudek, J."Elective arteriovenous fistula ligation for prevention of lymphedema in a patient with breast cancer before ipsilateral axillary lymph node dissection: A case report". Oncology Letters 30, no. 3 (2025): 420. https://doi.org/10.3892/ol.2025.15166
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