Dennis R. Holmes, M.D., F.A.C.S., is an internationally renowned breast cancer expert with locations in Beverly Hills, Santa Monica, Glendale, and Los Angeles, California, and is one of very few surgeons in the U.S. performing lymph node-sparing surgery, a specialized technique to minimize the side effects of lymph node surgery.
Removal or injury to arm lymph nodes and lymph vessels that originate from the arm may cause lymphedema or chronic arm swelling. Under normal circumstances, a surgeon is unable to distinguish arm lymph nodes/vessel from breast lymph nodes/vessels, because they look the same and are located in the same area of the armpit. Lymph node-sparing surgery using the axillary reverse mapping technique utilized a blue dye injected into the arm which turns the arm lymph nodes blue. This makes them visible to capable of being distinguished for arm lymph nodes/vessels.
Lymph node-sparing surgery can be performed whenever lymph node surgery is needed for management of breast cancer. In it simplest form, lymph node sparing surgery can be performed using axillary reverse mapping at the time of sentinel node biopsy or axillary node dissection to identify arm lymph nodes and lymph vessels which may be avoided or spared. Another strategy of sparing lymph node is to offer women with positive lymph nodes chemotherapy with the goal of clearing away cancer within the nodes. If positive nodes can be converted to normal or negative lymph nodes, then Dr. Holmes can reduce the number of lymph nodes that must be removed at the time of lymph node surgery.
Lymphedema or chronic arm swelling occurs in approximately 5% women undergoing sentinel node biopsy and 15-30% of women undergoing axillary node dissection, depending on whether or not radiation is also needed. Lymphedema is treatable, but not usually curable. The best solution is prevention by limiting the number of lymph node removed and avoiding removal or disruption of lymph node and vessels that drain the arm.
Anyone undergoing lymph node surgery is a candidate for lymph node-sparing surgery.
"He treated my daughter who had stage one breast cancer. He put us at ease and calmed our fears , he was the perfect surgeon for our situation."
"He has to be one of the most incredible doctor that I've been blessed to have on my survival team. He's saved my life! I'm a proud 28 yr B C survivor."
"Dr. Holmes is kind, professional, and has a lot of patience answering every question you might have."
"Great and SMART staff. Great place with ZERO infection rate. I was back to work after surgery way sooner then expected! Awesome place great center."
“Thank you so much for being caring and patient with me during this hard transition. I really appreciate your professionalism and dedication.”
“God Bless you, your mind, and your hands, so you may continue to help all women with breast cancer! We thank you for everything that you have done!"
"This week I celebrated my 55th birthday. I cannot be thankful enough for your help in giving me another chance to enjoy waking up each day."