Risk Factors of Arm Lymphedema in Breast Cancer Patients

Koçak, Zafer; Overgaard, Jens

doi:10.1080/028418600750013168

Cited by 79 publications

(16 citation statements)

References 15 publications

(24 reference statements)

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“…BCRL is a serious complication that impairs the upper extremity functions and quality of life of breast cancer patients. The progression of BCRL is related to various risk factors including surgery, radiation therapy, chemotherapy, diagnostic time, pathological lymph node condition, infection, and weight gain [ 4 5 6 ]. Prevention by risk factor management is an important part of lymphedema treatment [ 7 ], and several studies have reported that the treatment effects, prognosis of BCRL, and the quality of life of breast cancer patients are greatly affected by the patients' awareness of BCRL and its risk factors [ 8 9 10 ].…”

Section: Introductionmentioning

confidence: 99%

A Survey of the Status of Awareness of Lymphedema in Breast Cancer Patients in Busan-Gyeongnam, Korea

et al. 2015

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ObjectiveTo support the establishment of lymphedema education plans and the actual practice of education by investigating the current lymphedema awareness status of Korean breast cancer patients.Methodscross-sectional population survey was conducted in 116 breast cancer patients in the Busan-Gyeongnam area. The survey included questions regarding demographic characteristics, breast cancer-related lymphedema (BCRL) risk factors, and characteristics and treatments of the disease. Some of the items were scored to determine the level of awareness. The items that affect the awareness of lymphedema were investigated by statistical analysis.ResultsEighty-one of the 116 patients answered that they had heard of lymphedema, and 30 of them (25.86%) had received explanations about the possibility of lymphedema before surgery. Only 20 patients (17.25%) knew that lymphedema is not a completely curable disease, 24 patients (20.68%) thought that lymphedema does not require any treatment, and only 56 patients (48.27%) knew that lymphedema is treated in the Department of Rehabilitation Medicine. The main factors that affected patients' awareness of lymphedema were their age, chemotherapy, duration of breast cancer, and lymphedema treatment history.ConclusionThe majority of survey participants who were breast cancer patients either lacked awareness of BCRL or had false ideas about it, indicating the inadequate level of education provided for lymphedema. In the case of breast cancer diagnosis, early and continuous education for future management is essential, and the framework for the provision of education including education protocols related to age, disease duration, and lymphedema treatment is needed.

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Section: Introductionmentioning

confidence: 99%

A Survey of the Status of Awareness of Lymphedema in Breast Cancer Patients in Busan-Gyeongnam, Korea

et al. 2015

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“…The procedure of radical ALND implies a significant increase in morbidity, such as lymphedema or paresthesia of the arm [8]. Provided that the preoperative assessment was correct, the precision of histological staging by SNB is very high and postoperative morbidity is significantly minimized [9]. Recently, omission of radical ALND in certain cases of positive sentinel nodes has been discussed [10,11].…”

Section: Introductionmentioning

confidence: 99%

Real-time ultrasound elastography in 180 axillary lymph nodes: elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases

Wojcinski

DuPont²,

Schmidt

et al. 2012

BMC Med Imaging

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BackgroundTo determine the general appearance of normal axillary lymph nodes (LNs) in real-time tissue sonoelastography and to explore the method′s potential value in the prediction of LN metastases.MethodsAxillary LNs in healthy probands (n=165) and metastatic LNs in breast cancer patients (n=15) were examined with palpation, B-mode ultrasound, Doppler and sonoelastography (assessment of the elasticity of the cortex and the medulla). The elasticity distributions were compared and sensitivity (SE) and specificity (SP) were calculated. In an exploratory analysis, positive and negative predictive values (PPV, NPV) were calculated based upon the estimated prevalence of LN metastases in different risk groups.ResultsIn the elastogram, the LN cortex was significantly harder than the medulla in both healthy (p=0.004) and metastatic LNs (p=0.005). Comparing healthy and metastatic LNs, there was no difference in the elasticity distribution of the medulla (p=0.281), but we found a significantly harder cortex in metastatic LNs (p=0.006). The SE of clinical examination, B-mode ultrasound, Doppler ultrasound and sonoelastography was revealed to be 13.3%, 40.0%, 14.3% and 60.0%, respectively, and SP was 88.4%, 96.8%, 95.6% and 79.6%, respectively. The highest SE was achieved by the disjunctive combination of B-mode and elastographic features (cortex >3mm in B-mode or blue cortex in the elastogram, SE=73.3%). The highest SP was achieved by the conjunctive combination of B-mode ultrasound and elastography (cortex >3mm in B-mode and blue cortex in the elastogram, SP=99.3%).ConclusionsSonoelastography is a feasible method to visualize the elasticity distribution of LNs. Moreover, sonoelastography is capable of detecting elasticity differences between the cortex and medulla, and between metastatic and healthy LNs. Therefore, sonoelastography yields additional information about axillary LN status and can improve the PPV, although this method is still experimental.

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“…Lymph edema is the accumulation of a high-protein edema fluid in the interstitial tissue as a result of the functional overload of the lymphatic system in which lymph volume exceeds transport capabilities and the lymphatic system becomes overwhelmed, causing lymphatic insufficiency or failure 1 ) .…”

Section: Introductionmentioning

confidence: 99%

Effects of phase I complex decongestive physiotherapy on physical functions and depression levels in breast cancer related lymph edema

et al. 2015

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[Purpose] Breast cancer-related upper extremity lymph edema is known to cause physical, functional and psychological impairments in women after modified radical mastectomy. The aim of this study was to investigate the effects of phase I Complex Decongestive Physiotherapy (CDP) on physical functions and depression levels in women with breast cancer-related upper extremity lymph edema. [Subjects and Methods] Fifty-eight subjects with breast cancer-related upper extremity lymph edema were the subjects of this study. The arm circumference, shoulder range of motion (ROM), muscle strength and depression levels of the subjects were assessed before and after phase I CDP treatment. [Results] After phase I CDP, there was a statistically significant reduction in circumference measurements at all levels of the affected arm. There was not any statistically significant difference in muscle strength after CDP. The shoulder ROM improved after treatment. There was a significant reduction in the Beck Depression Inventory score. A significant positive correlation was found between depression levels and circumference measurement. [Conclusion] Based on the results we suggest that by reducing limb volume, beside improving physical functions, phase I CDP can affect psychological status, especially depression which is very common in women with breast cancer-related upper extremity lymph edema.

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Risk Factors of Arm Lymphedema in Breast Cancer Patients

Cited by 79 publications

References 15 publications

A Survey of the Status of Awareness of Lymphedema in Breast Cancer Patients in Busan-Gyeongnam, Korea

A Survey of the Status of Awareness of Lymphedema in Breast Cancer Patients in Busan-Gyeongnam, Korea

Real-time ultrasound elastography in 180 axillary lymph nodes: elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases

Effects of phase I complex decongestive physiotherapy on physical functions and depression levels in breast cancer related lymph edema

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