Lymphœdème du membre supérieur révélant un cancer du sein

Vignes, S.; Arrault, M.; Bonhomme, S.; Spielmann, M.

doi:10.1016/j.revmed.2007.02.017

Cited by 12 publications

(5 citation statements)

References 15 publications

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“…Moreover, only a few centres are equipped for scintigraphy, and interpretation of the findings remains subtle. But for ULL, particularly in women, breast cancer must be eliminated, as lymphoedema can be its first manifestation 4,5 . Clinical examination suffices to diagnose lymphoedema: finding a chronic and painless swelling beginning on the dorsal side of the hand.…”

Section: Discussionmentioning

confidence: 99%

“…But for ULL, particularly in women, breast cancer must be eliminated, as lymphoedema can be its first manifestation. 4,5 Clinical examination suffices to diagnose lymphoedema: finding a chronic and painless swelling beginning on the dorsal side of the hand. Ultrasonography does not visualize any venous abnormality.…”

Section: Discussionmentioning

confidence: 99%

“…For the forearm and upper arm, a 2‐cm difference in comparison with the contralateral limb was required to confirm the diagnosis, as previously published for ULL after breast cancer treatment 3 . Breast cancer was ruled out in all women before considering increased upper‐limb volume primary lymphoedema, based on mammography, ultrasonography and, sometimes, magnetic resonance imaging, because lymphoedema can be the first sign of breast cancer 4,5 . Other differential diagnoses, e.g.…”

Section: Methodsmentioning

confidence: 99%

“…3 Breast cancer was ruled out in all women before considering increased upper-limb volume primary lymphoedema, based on mammography, ultrasonography and, sometimes, magnetic resonance imaging, because lymphoedema can be the first sign of breast cancer. 4,5 Other differential diagnoses, e.g. lymphoedema-associated rheumatic diseases, reflex sympathetic dystrophy, skin diseases, thoracic outlet syndrome or infections, were ruled out clinically.…”

Section: Patientsmentioning

confidence: 99%

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Primary upper-limb lymphoedema

Vignes¹,

Arrault²,

Yannoutsos³

et al. 2012

British Journal of Dermatology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

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Primary upper-limb lymphoedema

Vignes¹,

Arrault²,

Yannoutsos³

et al. 2012

British Journal of Dermatology

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“…La survenue d'un lymphoedème du membre supérieur chez une femme sans antécédent particulier doit faire chercher [par l'examen clinique, l'écho-mammographie, l'imagerie par résonance magnétique (IRM)] un cancer du sein dont le lymphoedème peut être la première manifestation [36,37]. Un écho-Doppler est systématique lors de l'apparition ou l'aggravation d'un lymphoedème [38].…”

Section: Examens Complémentairesunclassified

Lymphœdèmes secondaires des membres

Vignes¹

2010

La Presse Médicale

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Cytologically proven axillary lymph node metastases are eradicated in patients receiving preoperative chemotherapy with concurrent trastuzumab for HER2‐positive breast cancer

Baena-Cañada

Estalella

Rosado

2010

Cancer

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We read the original article by Dominici et al 1 regarding the complete eradication of axillary lymph node metastases in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer who were treated with trastuzumab-containing neoadjuvant chemotherapy. The exquisite sensitivity of breast cancer to this treatment may generate an axillary lymph node complete pathological response that, as a counterpart, causes the stromal and vascular changes that give rise to the appearance of lymphedema before surgery. A patient aged 48 years was diagnosed with an invasive ductal carcinoma of the left breast with positive estrogen receptors, negative progesterone receptors, and positive HER2 in clinical stage IIIB (T4bN2M0). She was treated with four 21-day cycles of doxorubicin at a dose of 60 mg/m 2 and cyclophosphamide at a dose of 600 mg/m 2 , both administered intravenously. After the fourth cycle, the patient developed left arm lymphedema. Venous thrombosis was discounted by Doppler ultrasound. The patient completed the neoadjuvant treatment with four 21-day cycles of docetaxel at a dose of 100 mg/m 2 and trastuzumab at a dose of 6 mg/kg (8-mg/kg loading dose), both administered intravenously. During this treatment, the clinical remission of the mammary and axillary disease was maintained, and the edema of the arm increased. The histopathological result of modified radical mastectomy was the total absence of tumor, and marked postchemotherapy changes. During the axillary lymphadenectomy, only 3 lymphatic ganglia were recognized, all of which were free from metastasis, with interstitial fibrosis and lymphoid depletion. Also recognized were several foci of fibrosis with a scarce lymphoid population, suggestive of pre-existing lymphatic ganglia with changes produced by the chemotherapy.To the best of our knowledge, there are no descriptions in the literature of the appearance of lymphedema in this context.

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Lymphœdème du membre supérieur révélant un cancer du sein

Cited by 12 publications

References 15 publications

Primary upper-limb lymphoedema

Primary upper-limb lymphoedema

Lymphœdèmes secondaires des membres

Cytologically proven axillary lymph node metastases are eradicated in patients receiving preoperative chemotherapy with concurrent trastuzumab for HER2‐positive breast cancer

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