Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

Nielsen, Ilsa; Gordon, Susan J.; Selby, Anita

doi:10.1016/j.ctrv.2007.11.002

Cited by 39 publications

(34 citation statements)

References 71 publications

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“…Doença avançada, mastectomia, RT axilar, IMC > 25. Nielsen et al 26 Revisão sistemática --Ellis 27 Revisão bibliográfica Deficiência do sistema linfático, por meio de traumatismos, doenças ou fatores genéticos. Petrek et al 28 Coorte 923 mulheres no P.O.…”

Section: Dados Do Artigounclassified

“…Rett e Lopes 24 O linfedema é resultado de uma sobrecarga funcional do sistema linfático, uma vez que o volume da linfa excede o seu transporte pelos coletores e a absorção pelos capilares linfáticos. Nielsen et al 26 As orientações educativas preventivas trazem benefícios à prevenção do linfedema. Ellis 27 A deficiência do sistema linfático pode ocorrer por meio de traumatismos, doenças ou fatores genéticos.…”

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Avaliação dos fatores de risco no linfedema pós-tratamento de câncer de mama

2010

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IntroduçãoSegundo a Sociedade Internacional de Linfologia 1 , o linfedema é uma manifestação clínica de insuficiência do sistema linfático, com consequente desordem no transporte de linfa, podendo acometer face, tórax, pescoço, membros e pelve, sendo comum em pós-operatório de cirurgias e radioterapias para tratamentos oncológicos. Além disso, pode ocorrer o linfedema primário, devido a uma deficiência na formação vascular linfática, ou ainda um linfedema secundário a um episódio de erisipela ou trombose venosa profunda, ou secundário à insuficiência venosa crônica, traumas ou úlceras.Já para o câncer de mama, o linfedema é a complicação pós-operatória de maior morbidade, e seus efeitos adversos afetam diretamente a qualidade de vida das pacientes. Embora sua incidência esteja diminuindo devido ao diagnóstico precoce e ao progresso nas estratégias terapêuticas ResumoA principal complicação tardia no pós-operatório de câncer de mama é o desenvolvimento do linfedema, uma doença crônica, progressiva, geralmente incurável. O aumento do volume do membro pode desfigurar a imagem corporal, assim como aumentar a morbidade física e psicológica da paciente, além de promover significativo prejuízo para as funções. O presente estudo foi desenvolvido por meio de uma revisão sistemática a partir do cruzamento aleatório das palavras-chave: "linfedema", "compensações linfáticas", "sistema linfático", "dissecção axilar", "fatores de risco" e "câncer de mama". Foram selecionados 18 artigos entre os anos de 1979 e 2009, nos quais foram encontrados como principais fatores de risco para o desenvolvimento do linfedema a radioterapia, radioterapia axilar, infecção, dissecção axilar seguida de radioterapia, obesidade, número de linfonodos retirados e comprometidos e agressividade da cirurgia. As formas de compensação linfática após a dissecção axilar, como as anastomoses linfolinfáticas, podem ser prejudicadas pela formação cicatricial, seroma pós-operatório, radioterapia e exercícios inadequados para reabilitação de ombro no câncer de mama.Palavras-chave: Linfedema; sistema linfático; excisão de linfonodo; fatores de risco; neoplasias da mama. AbstractThe main late complication after the surgery of breast cancer is the development of lymphedema, a chronic, progressive, usually incurable disease. The increase in the volume of the limb can disfigure the body image and develop the physical and psychological morbidity of the patient, promoting significant damage to the functions. This study was developed through a systematic review from the randomized crosschecking of the keywords "lymphedema", "lymphatic compensation", "lymphatic system", "axillary dissection", "risk factors" and "breast cancer". Eighteen articles were selected, between 1979 and 2009, in which radiotherapy, axillary radiation, infection, axillary dissection followed by radiotherapy, obesity, number of removed and impaired lymph nodes and aggressiveness of surgery were found as main risk factors for the development of lymphedema. The way of compensation after the lymphati...

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Avaliação dos fatores de risco no linfedema pós-tratamento de câncer de mama

2010

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“…BCRL is the most commonly reported complication after breast cancer (BC) related surgery and adversely affects the quality of life of BC patients. Although its incidence is decreasing due to early diagnosis, changing treatment strategies, and sentinel lymph node biopsy techniques, BCRL still remains a significant concern for patients and their health care providers [1,2]. Neither medical nor surgical treatment provides a cure for BCRL; therefore, risk stratification and prevention are the most important strategies in decreasing morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…Breast cancer-related upper extremity lymphedema (BCRL) is a chronic, progressive, and multifactorial process characterized by swelling in the arm and adjacent trunk and changes to the skin and underlying tissues [1]. BCRL is the most commonly reported complication after breast cancer (BC) related surgery and adversely affects the quality of life of BC patients.…”

Section: Introductionmentioning

confidence: 99%

“…Disease related factors include tumor stage at time of diagnosis, pathologic nodal status, number of removed lymph nodes, and the location of the tumor in the breast [8,9]. Patient related factors include age at diagnosis, high body mass index (BMI), hypertension, history of infection or inflammation, hand dominance, and excessive use of the affected limb [1,[10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for breast cancer-related upper extremity lymphedema: Is immediate autologous breast reconstruction one of them?

et al. 2009

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AbstractBreast cancer related upper extremity lymphedema (BCRL) reduces the quality of life of those who have had surgery for breast cancer. The aim of this study is to evaluate the risk factors for BCRL and determine whether immediate autologous tissue breast reconstruction is one of them. A case control study was conducted comparing patients with BCRL (n=97) to surgically treated breast cancer patients without BCRL (control, n=126). The groups were matched for age, type of breast surgery and radiation therapy. Postoperative upper extremity infection, body mass index (BMI), occupation (level of hand-use), and immediate autologous tissue breast reconstruction were investigated as a risk factor of BCRL. Mastectomy was performed on 47.6 % (n=60) and 37.2% (n=36) of patients in the control and the BCRL groups, respectively. Eight patients (13.3%) had immediate autologous tissue breast reconstruction in the control mastectomy group. Six of 36 BCRL patients (16.7%) underwent mastectomy with immediate autologous tissue breast reconstruction. There was no significant difference between groups with respect to incidence or method of immediate reconstruction (p=0.65). Patient occupation (level of hand use) was found to be positively correlated to development of BCRL (p=0.0001). Upper extremity infection rate was 22.7% in the BCRL group and 4.0% in the controls (p=0.0001). The mean BMI in the control and BCRL groups 26.8 kg/m2 and 29.1kg/m2, respectively (p=0.003). In conclusion, in this study characteristics positively associated with development of BCRL included occupation, infection, and increased BMI. Immediate reconstruction of the breast was not found as a risk factor for BCRL. However larger studies are needed, to further evaluate the effect of breast reconstruction on BCRL.

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