Until recently, complex treatment of breast cancer included mandatory regional lymphadenectomy regardless lymph node status. Radiotherapy aggravates damage to lymphatic system of the upper limb. Lymphostasis is an irreversible process. Effective treatment of this disease is achieved only by surgical methods. Surgical treatment can be divided into 3 approaches: microsurgical techniques, liposuction and resections. Various microsurgical options (lympho-venous anastomoses, lymph node transplantation) are effective for upper limb lymphedema ISL stage I-II. Damage of lymphatic vessels following breast cancer treatment is aggravated by recurrent erysipelas and disease progresses without therapy. The manuscript is devoted to diagnosis and treatment of upper limb lymphedema ISL stage III. The authors report patients with lymphostasis stage III, long-term follow-up and ineffective therapy. Lymphography is a gold diagnostic standard to assess the status of lymphatic collectors. The authors also proposed two-stage treatment for patients with lymphedema ISL stage III ensuring maximum regression of edema, reduction of complication rate and hospital-stay. Treatment was followed by stable regression of upper limb edema and life quality improvement.

Keywords. lymphostasis, lymphedema, lymphatic edema, breast cancer, liposuction, excess tissue resection