Ultrasonografic changes in the axillary vein of patients with lymphedema after mastectomy

Abreu, Gilberto Ferreira De; Pitta, Guilherme Benjamin Brandão; Araújo, Marcelo; Castro, Ángel de; Azevedo, Walter Ferreira De; Miranda, Fausto

doi:10.1590/0100-69912015002004

Cited by 11 publications

(7 citation statements)

References 31 publications

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“…There is a consensus in the literature that first line therapy for breast cancer metastasis to the stomach is chemotherapy associated or not with hormonal blockade 5 , 6 , 9 , 12 , 13 . Mean survival after diagnoses of breast cancer metastasis to the stomach was of seven months (0 to 41 months) in the absence of complications 2 , 17 .…”

Section: Discussionmentioning

confidence: 97%

“…According to some authors, lobular carcinoma is the most common source of metastases to the stomach at a maximum rate of 83% of the cases 8 , 15 , 17 . In addition, even when mix ductal-lobular carcinomas are present, it is observed a predominant component of lobular carcinoma of the metastases to the digestive tract 2 , 3 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, metastases of breast cancer usually are directed to bones, lung, liver and brain. However, metastases to the stomach are very unusual and there are a few studies on this subject 2 , 6 , 8 , 9 , 11 , 12 , 13 , 17 , 20 . When these metastases occur, diagnostic confirmation based on immunohistochemistry is needed 2 , 3 , 5 , 7 , 11 , 14 , 16 , 20 .…”

Section: Introductionmentioning

confidence: 99%

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Breast Cancer Metastasis in the Stomach: When the Gastrectomy Is Indicated ?

Rodrigues

Tercioti-Júnior

Lopes

et al. 2016

ABCD, arq. bras. cir. dig.

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Background:Breast cancer is the most common malignant neoplasm in the female population. However, stomach is a rare site for metastasis, and can show up many years after initial diagnosis and treatment of the primary tumor. Aim:Analyze a case series of this tumor and propose measures that can diagnose it with more precocity. Methods:Were analyzed 12 patients with secondary gastric tumors. Immunohistochemistry has demonstrated that primary tumor was breast cancer. We retrieved information of age, histological type, interval between diagnosis of the primary breast cancer and its metastases, immunohistochemistry results, treatment and survival. Results:The mean age was 71.3 years (ranging 40-86). Ten cases had already been underwent mastectomy in the moment of the diagnosis of gastric metastasis. Two patients had diagnosis of both primary and secondary tumors concomitantly. At average, diagnosis of gastric metastasis was seven years after diagnosis of primary breast cancer (ranging 0-13). Besides, nine cases had also metastases in other organs, being bones the most affected ones. Immunohistochemistry of the metastases has shown positivity for CK7 antibody in 83.34%, estrogen receptor in 91.67%, progesterone receptor in 66.67% and AE1AE3 antibody in 75%, considering all 12 cases. Moreover, CK20 was absent significantly (66.67%). The positivity of BRST2 marker did not present statistical significance (41.67%). Eight cases were treated with chemotherapy associated or not with hormonal blockade. Surgical treatment of gastric metastasis was performed in four cases: three of them with total gastrectomy and one with distal gastrectomy. Follow-up has shown a mean survival of 14.58 months after diagnosis of metastasis, with only two patients still alive. Conclusion:Patients with a history of breast cancer presenting endoscopic diagnosis of gastric cancer it is necessary to consider the possibility of gastric metastasis of breast cancer. The confirmation is by immunohistochemistry and gastrectomy should be oriented in the absence of other secondary involvement and control of the primary lesion.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Breast Cancer Metastasis in the Stomach: When the Gastrectomy Is Indicated ?

Rodrigues

Tercioti-Júnior

Lopes

et al. 2016

ABCD, arq. bras. cir. dig.

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“…Venous wall thickening of axillary vein was observed on ultrasound in BCRL patients. These findings may be related to slight elevations in concentrations of FDP and D-dimer in plasma, although detailed mechanisms are not well known yet [ 26 ]. When levels of FDP and D-dimer are slightly elevated, they could be interpreted as false-positives.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Significance of Fibrin Degradation Products and D-Dimer in Patients With Breast Cancer-Related Lymphedema

et al. 2019

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ObjectiveTo find out whether levels of fibrin degradation products (FDP) and D-dimer are increased in breast cancer-related lymphedema (BCRL) as in many vascular diseases. FDP and D-dimer have been used in blood tests to help differentiate deep vein thrombosis in the diagnosis of lymphedema. Levels of FDP and D-dimer are often elevated in patients with BCRL.MethodsPatients with BCRL (group I), non-lymphedema after breast cancer treatment (group II), and deep venous thrombosis (group III) from January 2012 to December 2016 were enrolled. Levels of FDP and D-dimer were measured in all groups and compared among groups.ResultsMean values of FDP and D-dimer of group I were 5.614±12.387 and 1.179±2.408 μg/μL, respectively. These were significantly higher than their upper normal limits set in our institution. Levels of FDP or D-dimer were not significantly different between group I and group II. However, values of FDP and D-dimer in group III were significantly higher than those in group I.ConclusionValues of FDP and D-dimer were much higher in patients with thrombotic disease than those in patients with lymphedema. Thus, FDP and D-dimer can be used to differentiate between DVT and lymphedema. However, elevated levels of FDP or D-dimer cannot indicate the occurrence of lymphedema.

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“…[ 14 – 16 ] In addition, iatrogenic venous disruption is considered to be a key predisposing factor for lymphedema associated with surgery for breast cancer patients. [ 17 ] Intravenous insertion of wires or devices is known to be a key factor in causing deep vein thrombosis of the upper extremity, and 50% of cases involve central venous line insertion within the prior month. [ 18 ] In addition, venous thrombosis (17%–25%) and stenosis (14%–42%) have been reported as common venous complications of AVF surgery.…”

Section: Discussionmentioning

confidence: 99%

Lymphedema secondary to idiopathic occlusion of the subclavian and innominate veins after renal transplantation

Kim

Moon²,

Goo

et al. 2017

Medicine

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Rationale:Among the causes of swelling in the extremities of renal transplantation patients, secondary lymphedema caused by complete idiopathic obstruction of large veins is rare and may be difficult to diagnose and treat.Patient concerns:A 64-year-old man presented with severe edema and pain that occurred suddenly in the right arm.Diagnoses:The patient was diagnosed as stage-2 secondary lymphedema caused by idiopathic occlusion of the subclavian and innominate veins.Interventions:Lymphoscintigraphy and ascending venography of the right arm confirmed the diagnosis. Intensive complete decongestive therapy for lymphedema was performed.Outcomes:Following 2 weeks of active rehabilitation, the pain level and edema status were significantly improved.Lessons:When idiopathic swelling of the extremities occurs in renal transplant patients, secondary lymphedema caused by venous occlusion may be the cause. When direct intervention for the venous occlusion proves to be difficult, a conservative approach may be helpful.

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Ultrasonografic changes in the axillary vein of patients with lymphedema after mastectomy

Abstract: the prevalence of SA was higher in patients undergoing mastectomy with lymphedema than in those without lymphedema.

Cited by 11 publications

References 31 publications

Breast Cancer Metastasis in the Stomach: When the Gastrectomy Is Indicated ?

Breast Cancer Metastasis in the Stomach: When the Gastrectomy Is Indicated ?

Diagnostic Significance of Fibrin Degradation Products and D-Dimer in Patients With Breast Cancer-Related Lymphedema

Lymphedema secondary to idiopathic occlusion of the subclavian and innominate veins after renal transplantation

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