Lymphoedema of the arm.

Browse, N L

doi:10.1136/bmj.295.6589.3

Search citation statements

Order By: Relevance

Paper Sections

Select...

Introduction1

Citation Types

Supporting

Mentioning

Contrasting

Unclassified

Year Published

1998

2010

Publication Types

Select...

Article2

Relationship

Self Cite0

Independent2

Authors

Journals

Cited by 10 publications

(2 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is evidence to suggest that the swelling may gradually worsen over time but there is only a weak positive correlation between the degree of swelling and the duration of swelling [4]. The pathophysiology of lymphoedema has been attributed to an obstruction of the lymphatics after surgery, resulting in an increased downstream pressure, which is transmitted to the interstitium [5]. In the last few years this view has been substantially challenged, by the concept of lymphatic pump failure as an underlying cause of the disease [6].…”

Section: Introductionmentioning

confidence: 99%

An interstitial hypothesis for breast cancer related lymphoedema

Bates

2010

Pathophysiology

View full text Add to dashboard Cite

Breast cancer related lymphoedema (BCRL), the chronically swollen arm of patients that have been treated for breast cancer, is no longer considered to be a result of lymphatic obstruction as recent studies have identified failing peripheral lymphatic function as a principal contributing factor. The aetiology and pathophysiology that results in this lymphatic failure is not clearly understood, but it can occur with minimal or even in some cases no damage to the axillary lymph nodes, and evidence suggests that some patients are pre-disposed to develop the disease, and have poor lymphatic function in their non-affected arms. It has been shown that interstitial forces such as hydrostatic pressure, and interstitial fluid velocity, can regulate both lymph flow, and lymph formation, and there is good evidence that interstitial forces are dysregulated in lymphoedema patients. Here I outline a hypothesis for how dysregulation of interstitial parameters could contribute to the generation of breast cancer related lymphoedema, by combining disparate strands of current evidence on the molecular and physiological control of interstitial and lymph flows. One mechanism by which lymphoedema could be generated is that a reduction in interstitial velocity results in increased VEGF-C production, which in low flow conditions, instead of acting on the lymphatics to increase pumping and lymphangiogenesis, acts on vasculature to increase fluid filtration. The resulting increase in interstitial pressure restores flow, but at the expense of increased volume and hence oedema. The evidence supporting the hypothesis and possible tests of it are presented and discussed.

show abstract

“…Rate von Lymphodemen wird mit 7-10% angegeben (Browse 1987, Scheunemann u. Willich 1992. -,,stehende Kreise" -,,Pumpgriffe" -,,Schopfgriff" -,,Drehgriff".…”

unclassified

Grundlagen und therapeutische Ideen zur Behandlung von Lymphödemen

Werner¹,

Strößenreuther²

1998

Phys Rehab Kur Med

View full text Add to dashboard Cite

Lymphoedema of the arm.

Cited by 10 publications

References 2 publications

An interstitial hypothesis for breast cancer related lymphoedema

Grundlagen und therapeutische Ideen zur Behandlung von Lymphödemen

Contact Info

Product

Resources

About