Early Detection of Lymphatic Disorder and Treatment for Lymphedema following Breast Cancer
- 1 August 2016
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Plastic and Reconstructive Surgery
- Vol. 138 (2), 192e-202e
- https://doi.org/10.1097/prs.0000000000002337
Abstract
Upper extremity edema following surgical treatment for breast cancer does not always result in chronic breast cancer–related lymphedema. Changes in the findings of indocyanine green lymphography and upper extremity volume following breast cancer surgery were observed prospectively to understand the early changes in lymphatic function and to establish a new strategy for early diagnosis and treatment of breast cancer–related lymphedema. Lymphatic function for 196 consecutive breasts was examined using indocyanine green lymphography and bilateral upper extremity volume before surgery and 1, 3, 6, 9, and 12 months after surgery. When a “stardust,” “diffuse,” or “no flow” pattern was observed, patients were diagnosed with lymphatic disorder and subsequently underwent conservative treatments such as compression sleeve therapy. In 35 patients, lymphatic disorder was observed after a mean of 5.2 ± 3.0 months after surgery. In 21 of these patients, no significant limb volume change was observed. In 14 patients, lymphatic disorder and volume change appeared simultaneously. In 11 of 35 patients, lymphatic function improved later, and compression therapy was discontinued. Lymph node dissection, radiation therapy to axillary lymph node, and the use of docetaxel chemotherapy were significant risk factors for lymphatic disorder. No patients experienced cellulitis during the study period. Lymphatic function disorder could be detected before volume changes. By early intervention with conservative treatments, lymphatic function improved in just under one-third of cases. Indocyanine green lymphography for high-risk patients may be useful for detecting lymphatic disorder early, thereby increasing the chance for disease cure. Therapeutic, IV.Keywords
This publication has 43 references indexed in Scilit:
- Upper Extremity Lymphedema IndexAnnals of Plastic Surgery, 2013
- Breast-Cancer Related Lymphedema: A Review of Procedure-Specific Incidence Rates, Clinical Assessment Aids, Treatment Paradigms, and Risk ReductionThe Breast Journal, 2012
- Indocyanine Green (ICG) Lymphography Is Superior to Lymphoscintigraphy for Diagnostic Imaging of Early Lymphedema of the Upper LimbsPLOS ONE, 2012
- Subjective and Objective Assessment of Edema during Adjuvant Chemotherapy for Breast Cancer Using Taxane-Containing Regimens in a Randomized Controlled Trial: The National Surgical Adjuvant Study of Breast Cancer 02Oncology, 2012
- Adjuvant Chemotherapy, with or without Taxanes, in Early or Operable Breast Cancer: A Meta-Analysis of 19 Randomized Trials with 30698 PatientsPLOS ONE, 2011
- Assessment of Breast Cancer-Related Arm Lymphedema—Comparison of Physical Measurement Methods and Self-ReportCancer Investigation, 2009
- Incidence and risk factors of breast cancer lymphoedemaJournal of Clinical Nursing, 2008
- Reliability Study of Measurements for Lymphedema in Breast Cancer PatientsAmerican Journal of Physical Medicine & Rehabilitation, 2008
- Lymphedema Secondary to Postmastectomy Radiation: Incidence and Risk FactorsAnnals of Surgical Oncology, 2004
- Prognostic factors for lymphedema after primary treatment of breast carcinomaCancer, 2001