Lymphedema: current issues in research and management

Petrek, Jeanne A.; Pressman, Peter I.; Smith, Robert A.

doi:10.3322/canjclin.50.5.292

Cited by 246 publications

(183 citation statements)

References 55 publications

(72 reference statements)

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“…32 In literature, a broad range of incidence for post-operative lymph oedema, varying widely from 6% to 56% in ALND patients, depending on definition, method of measurement, extent of axillary surgery, number of different surgeons, choice of adjuvant therapy and time elapsed since operation. 17,33 Across treatment and time since treatment, approximately a quarter of patients are believed to develop arm oedema. 34 The addition of radiotherapy to the dissected axilla is thought to be a strong contributor to lymph oedema.…”

Section: Discussionmentioning

confidence: 99%

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

Schijven¹,

Vingerhoets²,

Rutten³

et al. 2003

European Journal of Surgical Oncology (EJSO)

255

125

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Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy Schijven, M.; Vingerhoets, Ad; Rutten, H.J.T.; Nieuwenhuijzen, G.A.P.; Roumen, R.M.H.; Bussel, M.E.; Voogd, A.C. General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.-Users may download and print one copy of any publication from the public portal for the purpose of private study or research -You may not further distribute the material or use it for any profit-making activity or commercial gain -You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright, please contact us providing details, and we will remove access to the work immediately and investigate your claim.Download date: 12. mei. 2018 EJSO 2003; 29: 341±350 doi:10.1053/ejso.2002.1385 Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy Aims: The use of axillary lymph node dissection (ALND) in women with breast cancer is associated with considerable morbidity. Sentinel node biopsy (SNB) removes the lymph node in the axillary basin indicative for receiving first lymphatic drainage from the breast. This study compares the nature and severity of physical morbidity among breast cancer patients who underwent primary surgery for breast cancer combined with either ALND or SNB. Also, it assesses influence of subsequent radiotherapy on morbidity. Method: Two hundred and thirteen ALND patients were compared with 180 SNB patients retrospectively. Morbidity was measured using a disease-specific quality-of-life questionnaire. Results: Patients' demographic characteristics were alike. The axillary procedure is the strongest and most consistent factor in explaining differences in a variety of self-reported complaints. Patients having had SNB have a 3.2-fold lower risk of experiencing pain, a 5-fold lower risk of lymph oedema, a 7.7-fold lower risk of numbness, a 3.7-fold lower risk of tingling sensations, a 7.1-fold lower risk of loss of strength in arm/hand, a 3.6-fold lower risk of loss of active motion range of the arm and a 2.9-fold lower risk of impaired use of the arm. Axillary radiation therapy adds to complaints next to the axillary surgical procedure by increasing the risk of lymph oedema 2.4-fold and enhancing the risk of impaired use of the arm by 2.6-fold. Axillary radiation therapy does not explain lymph oedema by itself. Conclusion: SNB is associated with less morbidity compared to ALND in patients with primary breast cancer.

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Section: Discussionmentioning

confidence: 99%

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

Schijven¹,

Vingerhoets²,

Rutten³

et al. 2003

European Journal of Surgical Oncology (EJSO)

255

125

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“…26 Lymphoscintigraphy, a nuclear medicine imaging technique, along with other imaging technologies, have been used to investigate the pre-and post-operative risk of lymphoedema development in patients with breast cancer. [27][28][29] The uptake of this imaging modality in the clinical diagnostic process is not universal 30 and is the topic of continuing experimental evaluation. 31 New technologies such as bioimpedance may aid diagnosis and provide a level of accuracy in clinical examination not previously possible through traditional measurement techniques such as circumferential measures.…”

Section: Breast Cancer-related Lymphoedemamentioning

confidence: 99%

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

Nielsen

Gordon

Selby

2008

Cancer Treatment Reviews

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SummaryBreast cancer-related lymphoedema (BCRL) is a debilitating, distressing condition affecting approximately one in five breast cancer survivors (Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 2005;98:343-8). The evidence-base for breast cancer-related lymphoedema risk reduction advice is scant and contradictory, with most studies in the area limited by small numbers, retrospective design and other methodological inadequacies. Current advice has the capacity to profoundly alter quality of life following treatment for breast cancer. Health professionals should review the risk reduction advice they provide to reflect the current understanding of aetiology and risk factors. Further research is required to provide more evidence for the content, to identify optimal methods of precautionary education delivery and to determine the effect of the advice on the patient's quality of life and perception of recovery.

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“…These subjective symptoms and objective evaluations such as arm girths, ROM, and grip strength often did not match. Subjective symptom experience is the most important parameter for assessing physical function (Segerstrӧm et al 1991) and is often a major source of discomfort for patients (Petrek et al 2000). The more the patients perceive a certain symptom, the more likely they will behave to avoid that symptom (McLaughlin et al 2008).…”

Section: Discussionmentioning

confidence: 99%

The Perioperative Educational Program for Improving Upper Arm Dysfunction in Patients with Breast Cancer at 1-Year Follow-Up: A Prospective, Controlled Trial

Sato

Arinaga

Sato

et al. 2016

Tohoku J. Exp. Med.

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The many women with breast cancer who underwent axillary lymph node dissection (ALND) suffer from the upper arm dysfunction. In this study, we investigated the effectiveness of a perioperative educational program for improving upper arm dysfunction in breast cancer patients following ALND. This study was a sub-analysis of a previous controlled trial with an educational program. The subjects of this analysis included 64 patients following ALND who completed measurements at 12 months. The perioperative educational program consisted of monitoring of arm dysfunction, exercises, massage, and lifestyle adjustments. The intervention group (37 patients) received this perioperative educational program over 12 months, while 27 patients in the control group received written information about shoulder exercise from on-site staff only before surgery. Primary outcomes were shoulder range of motion (ROM), arm girth, and grip strength. Secondary outcomes were evaluated with the Subjective Perception of Post-Operative Functional Impairment of the Arm (SPOFIA) scores, the Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the Medical Outcome Study 36-Item Short-Form Health Survey v2 (SF-36v2). The SF-36v2 measures health-related quality of life (QOL). Primary and secondary outcomes were compared between groups at 1 week (after drainage tube removal) and 12 months after surgery, using the Mann-Whitney U test. The horizontal extension was significantly improved only in the intervention group. Moreover, the SPOFIA score was significantly improved in the intervention group, and other scores of the secondary outcomes were similar between the two groups. The perioperative educational program may improve postoperative upper arm dysfunction and symptoms.

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Lymphedema: current issues in research and management

Cited by 246 publications

References 55 publications

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

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

The Perioperative Educational Program for Improving Upper Arm Dysfunction in Patients with Breast Cancer at 1-Year Follow-Up: A Prospective, Controlled Trial

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