193 results on '"Breast Cancer Related Lymphedema"'
Search Results
2. The prevention and treatment of breast cancer- related lymphedema: A review
- Author
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Maureen P. McEvoy, Ameer Gomberawalla, Mark Smith, Francesco M. Boccardo, Dennis Holmes, Risal Djohan, Paul Thiruchelvam, Suzanne Klimberg, Jill Dietz, and Sheldon Feldman
- Subjects
breast cancer ,lymphedema ,breast cancer related lymphedema ,axillary reverse mapping ,LyMPHA ,axillary surgery ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
BackgroundBreast cancer- related lymphedema (BCRL) affects about 3 to 5 million patients worldwide, with about 20,000 per year in the United States. As breast cancer mortality is declining due to improved diagnostics and treatments, the long-term effects of treatment for BCRL need to be addressed.MethodsThe American Society of Breast Surgeons Lymphatic Surgery Working Group conducted a large review of the literature in order to develop guidelines on BCRL prevention and treatment. This was a comprehensive but not systematic review of the literature. This was inclusive of recent randomized controlled trials, meta-analyses, and reviews evaluating the prevention and treatment of BCRL. There were 25 randomized clinical trials, 13 systemic reviews and meta-analyses, and 87 observational studies included.ResultsThe findings of our review are detailed in the paper, with each guideline being analyzed with the most recent data that the group found evidence of to suggest these recommendations.ConclusionsPrevention and treatment of BCRL involve a multidisciplinary team. Early detection, before clinically apparent, is crucial to prevent irreversible lymphedema. Awareness of risk factors and appropriate practice adjustments to reduce the risk aids are crucial to decrease the progression of lymphedema. The treatment can be costly, time- consuming, and not always effective, and therefore, the overall goal should be prevention.
- Published
- 2022
- Full Text
- View/download PDF
3. Minimize the extent and morbidity of axillary dissection for node-positive breast cancer patients: implementation of axillary lymph node dissection based on breast lymphatics level
- Author
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Qianqian Yuan, Jinxuan Hou, Yukun He, Yiqian Liao, Lewei Zheng, and Gaosong Wu
- Subjects
Breast cancer ,Axillary lymph node dissection ,Breast cancer related lymphedema ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Breast cancer-related lymphedema (BCRL) is associated with extensive axillary dissection. Axillary lymph node dissection (ALND) based on breast lymphatics level (BLL) was proposed to minimize the surgical extent for node-positive breast cancer patients. Methods A total of 156 consecutive sentinel lymph node-positive (SLN+) or clinically node-positive (cN+) patients underwent sentinel lymph node biopsy (SLNB) with indocyanine green and methylene blue (MB). The SLNs were injected with 0.1 ml MB before removal, and a standard ALND was subsequently performed. The nodes adjacent to the blue-stained axillary lymph nodes from the breast (bALNs) were sent for pathological examination separately by resecting serial tissue every 0.5 cm away from the marginal blue-stained bALNs. Then, a pilot study comparing ALND based on BLL and standard ALND was performed. Results BLL were successfully identified in 20 SLN+ (100%) and 134 cN+ (98.5%) patients. The median number of BLL was four, ranging from three to six. A horizontal line 1.0 cm away from the superior blue-stained bALN and a vertical line 1.0 cm away from the medial blue-stained bALN formed BLL II, III, and IV. All of the additional positive nodes were within 1.0 cm of the blue-stained bALNs. The minimized axillary dissection should resect upwards from the lowest BLL that contains the first confirmed negative blue-stained bALNs. In the pilot study, no patient developed axillary recurrence. Conclusion The ALND surgical procedure based on BLL could minimize the surgical extent for pathological node-positive breast cancer patients and potentially reduce the BCRL rate. Trial registration ChiCTR1800014247 .
- Published
- 2021
- Full Text
- View/download PDF
4. Effect of modified complex decongestion therapy in the treatment of breast cancer related lymphedema (改良版综合消肿疗法治疗乳腺癌相关淋巴水肿的效果观察)
- Author
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LI Qin (李芹) and SHI Fan (石帆)
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breast cancer ,radical mastectomy ,breast cancer related lymphedema ,complex decongestion therapy ,乳腺癌 ,乳腺癌根治术 ,乳腺癌相关淋巴水肿 ,综合消肿法 ,Nursing ,RT1-120 - Abstract
Objective To evaluate the effect of modified complex decongestion therapy (CDT) in the treatment of breast cancer related lymphedema (BCRL). Methods Totally 60 patients with BCRL were given complex CDT for four weeks. The degree of limb swelling was evaluated by arm circumference measurement, modified Rodnan skin scores(mRSSs) and the Breast Cancer and Lymphedema Symptoms Experience Index(BCLE-SEI), before intervention, 2 and 4 weeks after intervention respectively. Results The circumference of all measurement sites except for palm horizontal line decreased at 4 weeks after intervention compared with those before intervention (P<0. 05). The mRSSs and BCLE-SEI scores were reduced at 4 weeks after intervention compared with those before intervention (P<0. 05). Conclusion The modified CDT is effective in the treatment of BCRL. (目的 评估改良版综合消肿疗法治疗乳腺癌相关淋巴水肿的效果。方法 采用改良版综合消肿疗法对60例乳腺癌术后患侧上肢淋巴水肿患者干预4周, 在干预前、干预2周后、干预4周后, 分别采用上臂周径测量、上肢皮肤硬化程度评分量表(mRSSs)、乳腺癌淋巴水肿症状指数量表(BCLE-SEI)进行效果评价。结果 除掌横纹处周径外, 患侧上肢其他部位周径较干预前缩小, 差异有统计学意义(P<0. 05)。干预4周后, 患者mRSSs和BCLE-SEI均较干预前下降, 差异有统计学意义(P<0. 05)。结论 改良版综合消肿疗法对乳腺癌相关上肢淋巴水肿治疗效果良好。)
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- 2021
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- View/download PDF
5. Minimize the extent and morbidity of axillary dissection for node-positive breast cancer patients: implementation of axillary lymph node dissection based on breast lymphatics level.
- Author
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Yuan, Qianqian, Hou, Jinxuan, He, Yukun, Liao, Yiqian, Zheng, Lewei, and Wu, Gaosong
- Subjects
- *
AXILLARY lymph node dissection , *BREAST cancer , *CANCER patients , *SENTINEL lymph node biopsy , *LYMPHATICS , *OPERATIVE surgery - Abstract
Background: Breast cancer-related lymphedema (BCRL) is associated with extensive axillary dissection. Axillary lymph node dissection (ALND) based on breast lymphatics level (BLL) was proposed to minimize the surgical extent for node-positive breast cancer patients.Methods: A total of 156 consecutive sentinel lymph node-positive (SLN+) or clinically node-positive (cN+) patients underwent sentinel lymph node biopsy (SLNB) with indocyanine green and methylene blue (MB). The SLNs were injected with 0.1 ml MB before removal, and a standard ALND was subsequently performed. The nodes adjacent to the blue-stained axillary lymph nodes from the breast (bALNs) were sent for pathological examination separately by resecting serial tissue every 0.5 cm away from the marginal blue-stained bALNs. Then, a pilot study comparing ALND based on BLL and standard ALND was performed.Results: BLL were successfully identified in 20 SLN+ (100%) and 134 cN+ (98.5%) patients. The median number of BLL was four, ranging from three to six. A horizontal line 1.0 cm away from the superior blue-stained bALN and a vertical line 1.0 cm away from the medial blue-stained bALN formed BLL II, III, and IV. All of the additional positive nodes were within 1.0 cm of the blue-stained bALNs. The minimized axillary dissection should resect upwards from the lowest BLL that contains the first confirmed negative blue-stained bALNs. In the pilot study, no patient developed axillary recurrence.Conclusion: The ALND surgical procedure based on BLL could minimize the surgical extent for pathological node-positive breast cancer patients and potentially reduce the BCRL rate.Trial Registration: ChiCTR1800014247 . [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
6. Integrating Biological Advances Into the Clinical Management of Breast Cancer Related Lymphedema
- Author
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Marco Invernizzi, Gianluca Lopez, Anna Michelotti, Konstantinos Venetis, Elham Sajjadi, Leticia De Mattos-Arruda, Michele Ghidini, Letterio Runza, Alessandro de Sire, Renzo Boldorini, and Nicola Fusco
- Subjects
breast cancer related lymphedema ,pathobiology ,genetics ,breast cancer ,survivorship ,quality of life ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Breast cancer-related lymphedema (BCRL) occurs in a significant number of breast cancer survivors as a consequence of the axillary lymphatics' impairment after therapy (mainly axillary surgery and irradiation). Despite the recent achievements in the clinical management of these patients, BCRL is often diagnosed at its occurrence. In most cases, it remains a progressive and irreversible condition, with dramatic consequences in terms of quality of life and on sanitary costs. There are still no validated pre-surgical strategies to identify individuals that harbor an increased risk of BCRL. However, clinical, therapeutic, and tumor-specific traits are recurrent in these patients. Over the past few years, many studies have unraveled the complexity of the molecular and transcriptional events leading to the lymphatic system ontogenesis. Additionally, molecular insights are coming from the study of the germline alterations involved at variable levels in BCRL models. Regrettably, there is a substantial lack of predictive biomarkers for BCRL, given that our knowledge of its molecular milieu remains extremely puzzled. The purposes of this review were (i) to outline the biology underpinning the ontogenesis of the lymphatic system; (ii) to assess the current state of knowledge of the molecular alterations that can be involved in BCRL pathogenesis and progression; (iii) to discuss the present and short-term future perspectives in biomarker-based patients' risk stratification; and (iv) to provide practical information that can be employed to improve the quality of life of these patients.
- Published
- 2020
- Full Text
- View/download PDF
7. Axillary web syndrome in women after breast cancer surgery referred to an Oncological Rehabilitation Unit: which are the main risk factors? A retrospective case-control study.
- Author
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DE SIRE, A., LOSCO, L., CISARI, C., GENNARI, A., BOLDORINI, R., FUSCO, N., CIGNA, E., and INVERNIZZI, M.
- Abstract
OBJECTIVE: Axillary web syndrome (AWS) is a complication of surgical procedures in breast cancer (BC) patients. This condition with poorly understood incidence and etiology is characterized by the locoregional development of scar tissue, leading to subcutaneous cording, motion impairment and pain. The early identification of patients at risk for AWS would improve their clinical management. Here, we sought to characterize the prevalence of and the risk factors associated with AWS in BC women after surgery. PATIENTS AND METHODS: All patients with BC that underwent axillary surgery referred to an Outpatient Service for Oncological Rehabilitation were retrospectively collected. These women were assessed two weeks after the surgical procedure for their clinicopathologic features, type of therapeutic interventions, and AWS presence, laterality, pain, localization, cords type, and number of cords. RESULTS: Altogether, 177 patients (mean aged 60.65 ± 12.26 years) were included and divided into two groups: AWSPOS (n=52; 29.4%) and AWSNEG (n=125; 70.6%). Patients with tumor N ≥1 (OR=3.7; p<0.001), subjected to mastectomy, axillary lymph node dissection (ALND) and chemotherapy showed significant correlations with AWS onset (p<0.05). The range of shoulder motion limitation (OR=11.2; p<0.001) and the presence of breast cancer related lymphedema (OR=3.5; p=0.020) were associated with AWS. CONCLUSIONS: Mastectomy, ALND, chemotherapy, low staging tumors, shoulder range of motion limitations, and BCRL represent risk factors for AWS onset. Realizing new strategies for assessing the individual risk of AWS is a crucial clinical need to improve the health-related quality of life of BC survivors. [ABSTRACT FROM AUTHOR]
- Published
- 2020
8. Integrating Biological Advances Into the Clinical Management of Breast Cancer Related Lymphedema.
- Author
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Invernizzi, Marco, Lopez, Gianluca, Michelotti, Anna, Venetis, Konstantinos, Sajjadi, Elham, De Mattos-Arruda, Leticia, Ghidini, Michele, Runza, Letterio, de Sire, Alessandro, Boldorini, Renzo, and Fusco, Nicola
- Subjects
BREAST cancer ,LYMPHEDEMA ,PATHOLOGY ,LYMPHATICS ,CANCER patients - Abstract
Breast cancer-related lymphedema (BCRL) occurs in a significant number of breast cancer survivors as a consequence of the axillary lymphatics' impairment after therapy (mainly axillary surgery and irradiation). Despite the recent achievements in the clinical management of these patients, BCRL is often diagnosed at its occurrence. In most cases, it remains a progressive and irreversible condition, with dramatic consequences in terms of quality of life and on sanitary costs. There are still no validated pre-surgical strategies to identify individuals that harbor an increased risk of BCRL. However, clinical, therapeutic, and tumor-specific traits are recurrent in these patients. Over the past few years, many studies have unraveled the complexity of the molecular and transcriptional events leading to the lymphatic system ontogenesis. Additionally, molecular insights are coming from the study of the germline alterations involved at variable levels in BCRL models. Regrettably, there is a substantial lack of predictive biomarkers for BCRL, given that our knowledge of its molecular milieu remains extremely puzzled. The purposes of this review were (i) to outline the biology underpinning the ontogenesis of the lymphatic system; (ii) to assess the current state of knowledge of the molecular alterations that can be involved in BCRL pathogenesis and progression; (iii) to discuss the present and short-term future perspectives in biomarker-based patients' risk stratification; and (iv) to provide practical information that can be employed to improve the quality of life of these patients. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
9. Tackling the diversity of breast cancer related lymphedema: Perspectives on diagnosis, risk assessment, and clinical management.
- Author
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Michelotti, Anna, Invernizzi, Marco, Lopez, Gianluca, Lorenzini, Daniele, Nesa, Francesco, De Sire, Alessandro, and Fusco, Nicola
- Subjects
BREAST cancer - Abstract
Abstract Breast cancer related lymphedema (BCRL) develops as a consequence of surgical treatment and/or radiation therapy in a significant number of breast cancer patients. The etiology of this condition is multifactorial and has not yet been completely elucidated. Risk factors include high body mass index, radical surgical procedures (i.e. mastectomy and axillary lymph node dissection), number of lymph nodes removed and number of metastatic lymph nodes, as well as nodal radiation, and chemotherapy. However, these predisposing factors explain only partially the BCRL occurrence, suggesting the possible involvement of individual determinants. Despite the implementation of conservative approaches, BCRL still remains in a proportion of cases an incurable and progressive condition with major physical and psychological implications. To date, diagnostic methods and staging systems lack uniformity, leading to a possible underestimation of the real incidence of this condition, decreasing early detection and thus the possibility of an effective treatment. Several preventive and therapeutic options are available, both conservative and surgical, but are not included in a standardized intervention protocol, tailored on patient's specific characteristics. In this review, we provide a comprehensive overview of the current state-of-knowledge of BCRL management, novel advantages in the assessment of pre-operative evaluation and risk prediction and discuss strengths and weaknesses of diagnostic and treatment strategies currently accessible in clinical practice. Highlights • The etiology and risk factors of BCRL has not yet been completely elucidated. • Diagnostic methods, staging systems, follow-up schemes lack uniformity. • Several preventive and therapeutic options are available but are not included in a standardized intervention protocol. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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10. Assessment of Arm Volume Using a Tape Measure Versus a 3D Optical Scanner in Survivors with Breast Cancer-Related Lymphedema
- Author
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Judy Mastick, John A. Shepherd, Marilyn J. Hammer, Sarah P. Cate, Mei R. Fu, Niharika Dixit, Betty Smoot, Christine Miaskowski, Kord M. Kober, Bruce A. Cooper, Steven M. Paul, Yvette P. Conley, Lori Kennedy Madden, and Merisa Piper
- Subjects
Scanner ,medicine.medical_specialty ,Breast Cancer Lymphedema ,Immunology ,Breast Neoplasms ,3D optical scanner ,Breast cancer ,Cancer Survivors ,Breast Cancer ,medicine ,Humans ,Oncology & Carcinogenesis ,Lymphedema ,Cancer ,business.industry ,Original Articles ,lymphedema ,medicine.disease ,humanities ,circumference measures ,Arm ,Female ,Radiology ,arm volume ,Cardiology and Cardiovascular Medicine ,business ,Breast Cancer Related Lymphedema ,Volume (compression) ,Tape measure - Abstract
Background: Lymphedema (LE) is a significant clinical problem for breast cancer survivors. While the water displacement test and circumferential assessment using a tape measure (TM) are common methods to assess differences in arm volumes, faster and more reliable methods are needed. Study purposes, in breast cancer survivors (n = 294), were to compare the average total arm volumes and interlimb volume ratios for women with and without a history of LE, using a TM and three-dimensional (3D), whole-body surface scanner (3D scan); compare the level of agreement between arm volumes and interlimb volume ratios obtained using the two devices; and evaluate the percent agreement between the two measures in classifying cases of LE using three accepted thresholds. Methods and Results: Measurements were done using a spring-loaded TM and Fit3D ProScanner. Paired t-tests and Bland-Altman analyses were used to achieve the study aims. For circumference and volume comparisons, compared with the 3D scan, values obtained using the TM were consistently smaller. In terms of level of agreement, the Bland-Altman analyses demonstrated large biases and wide limits of agreement for the calculated arm volumes and volume ratios. In terms of the classification of caseness, using the 200-mL interlimb volume difference criterion resulted in 81.6% overall agreement; using the >10% volume difference between the affected and unaffected arms resulted in 78.5% overall agreement; and using the volume ratio ≥1.04 criterion resulted in 62.5% overall agreement. For all three accepted threshold criteria, the percentage of cases was significantly different between the TM and 3D scan techniques. Conclusions: The 3D technology evaluated in this study has the potential to be used for self-initiated surveillance for LE. With improvements in landmark identification and software modifications, it is possible that accurate and reliable total arm volumes can be calculated and used for early detection.
- Published
- 2022
11. Prediction of the Presence of Fluid Accumulation in the Subcutaneous Tissue in BCRL Using Texture Analysis of Ultrasound Images
- Author
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Fumiya Hisano, Etsuko Fujimoto, Shiori Niwa, Atsushi Fukuyama, Keisuke Nakanishi, Kazuhiro Shimamoto, Toyone Kikumori, Ayana Mawaki, Chika Oshima, and Sachiyo Watanabe
- Subjects
Male ,medicine.medical_specialty ,Breast Cancer Lymphedema ,Breast Neoplasms ,Subcutaneous Tissue ,Breast cancer ,hemic and lymphatic diseases ,Humans ,Medicine ,Lymphedema ,Texture (crystalline) ,Fluid accumulation ,skin and connective tissue diseases ,Ultrasonography ,business.industry ,Ultrasound ,Reproducibility of Results ,medicine.disease ,humanities ,body regions ,medicine.anatomical_structure ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Breast Cancer Related Lymphedema ,Subcutaneous tissue - Abstract
Background: Breast cancer-related lymphedema (BCRL) is a chronic swelling of the arm due to breast cancer treatment. Lymphedema is diagnosed and staged on the basis of limb circumference measuremen...
- Published
- 2022
12. Is There a Relationship Between Insulin Resistance and Breast Cancer-Related Lymphedema? A Preliminary Study
- Author
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Emine Kaya and Pınar Doruk Analan
- Subjects
Adult ,Blood Glucose ,Oncology ,medicine.medical_specialty ,Breast Neoplasms ,Body Mass Index ,Insulin resistance ,Breast cancer ,Internal medicine ,medicine ,Humans ,Insulin ,In patient ,Lymphedema ,Aged ,Metabolic Syndrome ,business.industry ,Middle Aged ,medicine.disease ,Obesity ,Blood insulin ,Female ,Insulin Resistance ,Metabolic syndrome ,Cardiology and Cardiovascular Medicine ,business ,Breast Cancer Related Lymphedema - Abstract
Background: High blood insulin levels, insulin resistance (IR), and obesity are components of metabolic syndrome (MetS). The literature has indicated a high risk of breast cancer in patients with M...
- Published
- 2022
13. Diagnostic Criteria for Breast Cancer-Related Lymphedema of the Upper Extremity: The Need for Universal Agreement
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Loryn K Bucci, Cheryl L. Brunelle, Yara W Kassamani, Madison C Bernstein, Tracy Nassif, Tessa C Gillespie, and Alphonse G. Taghian
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Early detection ,Physical examination ,Sequela ,medicine.disease ,Diagnostic tools ,Breast cancer ,Lymphedema ,Oncology ,Medicine ,Surgery ,business ,Intensive care medicine ,Breast Cancer Related Lymphedema - Abstract
With advances in breast cancer treatments and resultant increased survival rates, emphasis has been placed on post-treatment complications such as breast cancer-related lymphedema (BCRL), a chronic, negative sequela of breast cancer treatment. Accurate BCRL diagnosis necessitates longitudinal screening beginning at preoperative baseline. Prospective screening programs incorporating symptoms, objective measurements and clinical examination allow for early detection, early intervention, and improved BCRL prognosis. Currently, varied diagnostic criteria for BCRL exist, and this lack of consensus leads to variation in diagnostic and screening practices across institutions. This review outlines current diagnostic tools, including subjective and objective measurement methods and clinical examination. The merits of different criteria are evaluated and recommendations are made regarding measurement tools and diagnostic criteria for BCRL. Ultimately, the BCRL diagnostic process should be universalized and combine objective measurements, clinical evaluation, and symptoms assessment, and adhere to the best practices of the measurement tools used.
- Published
- 2021
14. Lymphatic dysfunction on indocyanine green lymphography in breast cancer patients undergoing sentinel lymph node biopsy
- Author
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Rikiya Nakamura, Naohito Yamamoto, Yoshitaka Kubota, Shinsuke Akita, Nobuyuki Mitsukawa, and Hideki Tokumoto
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Indocyanine Green ,medicine.medical_specialty ,Sentinel lymph node ,Breast Neoplasms ,chemistry.chemical_compound ,Postoperative Complications ,Breast cancer ,Biopsy ,Humans ,Medicine ,Lymphedema ,Coloring Agents ,medicine.diagnostic_test ,Sentinel Lymph Node Biopsy ,business.industry ,Lymphography ,medicine.disease ,Surgery ,Lymphatic system ,chemistry ,Lymphatic Metastasis ,Female ,Radiology ,business ,Indocyanine green ,Breast Cancer Related Lymphedema - Published
- 2021
15. Correlation of older age with severity of lymphedema in breast cancer survivors: A systematic review
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Antonio J. Forte, Maria T Huayllani, Francisco R. Avila, Daniel Boczar, and Gunel Guliyeva
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0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Ovid medline ,Secondary lymphedema ,business.industry ,General Medicine ,medicine.disease ,Correlation ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Lymphedema ,Breast cancer ,Oncology ,Outcome reporting ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Population study ,medicine.symptom ,business ,Breast Cancer Related Lymphedema - Abstract
BACKGROUND: Breast cancer is the most frequent cause of secondary lymphedema. Besides being progressive and chronic, lymphedema is usually hard to treat. That is why the clinicians are more focused on the prevention of its development and progression. OBJECTIVE: The aim of this study is to evaluate the possible relationship between the age of patients and the severity of breast cancer-related lymphedema (BCRL). METHODS: PubMed, Scopus, and Ovid MEDLINE databases were searched for articles, which described the relationship between aging and BCRL development. Two authors searched for and selected articles independently. RESULTS: Out of 562 studies selected, 8 studies met the inclusion criteria. However, 2 papers had the same study population, so only 7 were included in the final analysis. The total number of patients in those 7 studies was 3,904. Five out of 7 studies included in our review depicted the association of more severe forms of BCRL with older age. CONCLUSION: The final analysis showed that aging is related to the severity of BCRL. However, due to heterogeneity in study outcome reporting, the cause and effect relationship could not be determined.
- Published
- 2021
16. Self-care practices, patient education in women with breast cancer-related lymphedema
- Author
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Deveci, Zeynep, Karayurt, Özgül, and Eyigör, Sibel
- Subjects
Risk ,medicine.medical_specialty ,medicine.medical_treatment ,Psychological intervention ,Physical Therapy, Sports Therapy and Rehabilitation ,Affect (psychology) ,03 medical and health sciences ,Breast cancer ,0302 clinical medicine ,self-care ,medicine ,Rehabilitation ,030504 nursing ,business.industry ,medicine.disease ,Management ,Lymphedema ,education of patient lymphedema ,Adherence ,030220 oncology & carcinogenesis ,Family medicine ,Self care ,Original Article ,Surgery ,0305 other medical science ,business ,Breast Cancer Related Lymphedema ,Patient education - Abstract
Objectives: This study aims to evaluate self-care practices, sociodemographic and clinical factors that affect self-care and patient education among women with breast cancer-related lymphedema (BCRL). Patients and methods: This descriptive, cross-sectional study included a total of 102 women with BCRL (median age: 59 years; range, 35 to 80 years) who received lymphedema (LE) treatment at least once between July 2014 and May 2016. A Sociodemographic and Clinical Characteristics Form and the Lymphedema Self-care Survey were used to collect data via face-to-face interviews. Results: The median LE self-care practices score for women was 10 (range, 5 to 14). A total of 39.1% of the women implemented regular self-care. A statistically significant relationship was found between the score for perceived benefit of LE self-care and the score for self-care practice. No statistically significant difference was found among the self-care scores of the women with LE in terms of sociodemographic and clinical factors, except for education status. A total of 90.2% of the women with LE received self-care education, mostly from a physical therapy specialist and a physiotherapist. There was a statistically significant difference among self-care scores between patients who were educated and uneducated about LE. Conclusion: It is recommended that healthcare professionals should educate patients diagnosed with breast cancer to reduce LE risk and promote the implementation of self-care practices following the breast cancer surgery. Interventions should be made to increase the perceived benefits and reduce the perceived barriers and burden towards self-care behaviors to prevent and manage LE.
- Published
- 2021
17. Minimize the extent and morbidity of axillary dissection for node-positive breast cancer patients: implementation of axillary lymph node dissection based on breast lymphatics level
- Author
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Gaosong Wu, Yiqian Liao, Jinxuan Hou, Lewei Zheng, Qianqian Yuan, and Yukun He
- Subjects
Indocyanine Green ,Cancer Research ,medicine.medical_specialty ,Axillary lymph nodes ,Sentinel lymph node ,Breast Neoplasms ,Pilot Projects ,030230 surgery ,Breast cancer related lymphedema ,lcsh:RC254-282 ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Biopsy ,Axillary lymph node dissection ,Genetics ,medicine ,Humans ,Breast ,Lymphedema ,Prospective Studies ,Mastectomy ,Intraoperative Care ,medicine.diagnostic_test ,Sentinel Lymph Node Biopsy ,business.industry ,Dissection ,Axillary Lymph Node Dissection ,Middle Aged ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Lymphatic system ,medicine.anatomical_structure ,Oncology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Axilla ,Practice Guidelines as Topic ,Lymph Node Excision ,Female ,Lymph ,Radiology ,Sentinel Lymph Node ,business ,Research Article - Abstract
Background Breast cancer-related lymphedema (BCRL) is associated with extensive axillary dissection. Axillary lymph node dissection (ALND) based on breast lymphatics level (BLL) was proposed to minimize the surgical extent for node-positive breast cancer patients. Methods A total of 156 consecutive sentinel lymph node-positive (SLN+) or clinically node-positive (cN+) patients underwent sentinel lymph node biopsy (SLNB) with indocyanine green and methylene blue (MB). The SLNs were injected with 0.1 ml MB before removal, and a standard ALND was subsequently performed. The nodes adjacent to the blue-stained axillary lymph nodes from the breast (bALNs) were sent for pathological examination separately by resecting serial tissue every 0.5 cm away from the marginal blue-stained bALNs. Then, a pilot study comparing ALND based on BLL and standard ALND was performed. Results BLL were successfully identified in 20 SLN+ (100%) and 134 cN+ (98.5%) patients. The median number of BLL was four, ranging from three to six. A horizontal line 1.0 cm away from the superior blue-stained bALN and a vertical line 1.0 cm away from the medial blue-stained bALN formed BLL II, III, and IV. All of the additional positive nodes were within 1.0 cm of the blue-stained bALNs. The minimized axillary dissection should resect upwards from the lowest BLL that contains the first confirmed negative blue-stained bALNs. In the pilot study, no patient developed axillary recurrence. Conclusion The ALND surgical procedure based on BLL could minimize the surgical extent for pathological node-positive breast cancer patients and potentially reduce the BCRL rate. Trial registration ChiCTR1800014247.
- Published
- 2021
18. Factors Impacting Management of Breast Cancer-Related Lymphedema (BCRL) in Hispanic/Latina Breast Cancer Survivors: A Literature Review
- Author
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Elizabeth A. Anderson and Jane M. Armer
- Subjects
Oncology ,medicine.medical_specialty ,Physical activity ,Breast Neoplasms ,Article ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Cancer Survivors ,Internal medicine ,medicine ,Humans ,Lymphedema ,Survivors ,030212 general & internal medicine ,General Nursing ,030505 public health ,business.industry ,Sequela ,Hispanic or Latino ,medicine.disease ,humanities ,Quality of Life ,Female ,Health behavior ,0305 other medical science ,business ,human activities ,Breast Cancer Related Lymphedema - Abstract
Introduction: Breast cancer-related lymphedema (BCRL) is a treatment sequela with negative physical and psychological implications. BCRL is a lifetime concern for survivors and is currently incurable. With the increase in the Latino population in the United States, it is critical for the cancer care community to address factors that increase BCRL risk and negatively impact long-term quality of life. This literature review undertook to identify successful intervention strategies for BCRL among Latina survivors. Methods: Multiple databases were searched for published articles from 2006 to 2020. PRISMA guidelines were utilized. Data were extracted related to physical activity, diet, and psychosocial stress concerns of Latinas at risk for or living with BCRL. Results: Eleven interventions combined education and skill-building techniques to address physical activity, diet, and stress management for BCRL. Family involvement, peer-mentoring, culturally tailored education, and self-care skill development were identified as important for Latina survivors. Conclusion: Latina survivors may benefit from culturally tailored BCRL education programs and self-management interventions. Health care professionals and researchers should consider cultural influences when developing clinical intervention strategies to enhance outcomes for Latinas at risk for living with BCRL. In addition, including family members and/or peers in such strategies may be helpful to Latina survivors.
- Published
- 2021
19. The important role of nighttime compression in breast cancer–related lymphedema treatment
- Author
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Alphonse G. Ag and Cheryl L. Brunelle
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Breast Cancer Lymphedema ,Breast Neoplasms ,medicine.disease ,Compression (physics) ,Lymphedema ,Breast cancer ,Internal medicine ,medicine ,Humans ,Female ,business ,Breast Cancer Related Lymphedema - Published
- 2021
20. Age as a risk factor for breast cancer-related lymphedema: a systematic review
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Maria T Huayllani, Antonio J. Forte, Francisco R. Avila, Daniel Boczar, Gunel Guliyeva, and Xiaona Lu
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Pediatrics ,medicine.medical_specialty ,Oncology (nursing) ,business.industry ,Public health ,Evidence-based medicine ,medicine.disease ,Health informatics ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Lymphedema ,Oncology ,030220 oncology & carcinogenesis ,medicine ,030212 general & internal medicine ,Risk factor ,business ,Breast Cancer Related Lymphedema ,Medical literature - Abstract
Breast cancer-related lymphedema (BCRL) has been widely reported in the medical literature. Various patient characteristics, including age, have been investigated as possible risk factors for this disease entity, but the existence and direction of the cause-and-effect relationship are still unclear. In this review, we aimed to evaluate the effect of age on development of BRCL. PubMed, Scopus, and Ovid MEDLINE were searched for relevant articles, which were found to be published between 1974 and 2020. Twenty-six studies involving 19,396 patients were selected. The average age of patients was 54.9. 26 studies were included in the final analysis, and 13 articles reported no association between age and BCRL development. Though studies presented different findings, the majority did not identify age as a risk factor for development of lymphedema. However, the level of evidence of individual studies was low. In this article, we call attention to the need for uniform design of lymphedema studies and diagnosis. All patients should be informed and screened regularly for lymphedema during and after the treatment independent of their age.
- Published
- 2021
21. Is bioimpedance spectroscopy a useful tool for objectively assessing lymphovenous bypass surgical outcomes in breast cancer-related lymphedema?
- Author
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James A. Butterworth, Amanda Sutherland, Christa R. Balanoff, Amanda N. Hangge, Amanda L. Amin, S. Korentager, Kelsey E. Larson, and Jamie L. Wagner
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0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Future studies ,business.industry ,Anastomosis ,medicine.disease ,Oncologic surgery ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Lymphedema ,Breast cancer ,Oncology ,Bioimpedance spectroscopy ,030220 oncology & carcinogenesis ,Medicine ,In patient ,Radiology ,business ,Breast Cancer Related Lymphedema - Abstract
We sought to determine if bioimpedance spectroscopy (BIS) measurements can accurately assess changes in breast cancer-related lymphedema (BCRL) in patients undergoing lymphovenous bypass (LVB). Patients undergoing LVB for BCRL refractory to conservative treatment from 1/2015 to 12/2018 were identified from an IRB-approved prospectively maintained database at a single institution. All breast cancer patients were assessed with baseline BIS measurements prior to any oncologic surgery and serial BIS during follow-up office visits including before and after LVB. Clinicopathologic information, LVB operative details, and pre- and post-LVB operative BIS measurements were collected. Analysis focused on clinically significant BIS change, defined as two standard deviations (SD), and comparing LVB anastomosis to BIS changes. During the study timeframe, nine patients underwent LVB for treatment of BCRL. The majority (78%) received radiation, taxane chemotherapy, and underwent axillary dissection. An average of 5.6 LVB anastomoses were performed per patient. The average change in BIS following LVB was a 3SD reduction, indicating a clinically significant change. This improvement was stable over time, with persistent 2SD reduction at 22 months postoperatively. The number of LVB anastomoses performed did not significantly correlate with the degree of BIS change. This is the first study to utilize BIS measurements to assess response to LVB surgical intervention for BCRL. BIS measurements demonstrated clinically significant improvement after LVB, providing objective evidence in support of this surgical treatment for BCRL. BIS changes should be reported as key objective data in future studies assessing BCRL interventions, including response to LVB.
- Published
- 2021
22. Determination of Bioelectrical Impedance Thresholds for Early Detection of Breast Cancer-related Lymphedema
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Xinmei Ren, Miao Liu, Siyuan Wang, Houpu Yang, Shu Wang, Siyao Liu, Ying Cui, and Quanping Zhao
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Adult ,Youden's J statistic ,Early detection ,Breast Neoplasms ,Reference range ,Body Mass Index ,breast cancer ,Breast cancer ,Reference Values ,Republic of Korea ,Electric Impedance ,Humans ,Medicine ,Cutoff ,Prospective Studies ,Aged ,business.industry ,bioelectrical impedance ,General Medicine ,lymphedema ,Middle Aged ,medicine.disease ,Healthy Volunteers ,Lymphedema ,Case-Control Studies ,Arm ,Female ,business ,Nuclear medicine ,Bioelectrical impedance analysis ,Breast Cancer Related Lymphedema ,Research Paper - Abstract
Background: Bioelectrical impedance technology is a common technique used for the early detection of breast cancer-related lymphedema (BCRL). However, studies on the threshold value established by Inbody 720 device (Biospace, Korea) have been extremely limited. We aimed to determine its reference range and cutoff values. Methods: All patients were recruited from October 2017 to October 2019 at the Peking University People's Hospital Breast Center. In total, 82 patients with unilateral BCRL and 1305 healthy subjects were recruited in this study. We measured the extracellular fluid (ECF) ratio, extracellular water (ECW) ratio, as well as the single-frequency bioimpedance analysis (SFBIA) ratios at 1 and 5 kHz with the Inbody 720 device. The Youden index-based cutoff points, mean + 2SD and mean + 3SD values of these four indicators for both dominant and nondominant arms were also calculated. Results: Data were collected from 1387 women, including healthy subjects and patients with lymphedema. All statistical analyses were performed with SPSS. Significant differences were found between the two groups in the ECW, ECF, and SFBIA ratios. For the dominant affected arms, the Youden index-based cutoff points for the ECF, ECW, as well as SFBIA ratios at 1 and 5 kHz were 1.009, 1.008, 1.068, and 1.068, respectively. For the nondominant affected arms, the Youden index-based cutoff points were 1.014, 1.013, 1.047, and 1.048, respectively. The mean + 2 standard deviations (SD) and mean + 3SD values were also calculated. Conclusions: We determined the Youden index-based cutoff points, mean + 2SD and mean + 3SD values of the ECF, ECW, as well as SFBIA ratios at 1 and 5 kHz for both dominant and nondominant arms with data from 1305 healthy subjects. Next, the Youden index-based cutoff points, the mean + 2SD and mean + 3SD values were used to recognize patients with lymphedema. We found that the Youden index-based cutoff points and the mean + 2SD showed similar identification capacity on lymphedema, and they seemed to distinguish more patients with lymphedema than mean + 3SD values.
- Published
- 2021
23. Body Mass Index as a Major Risk Factor for Severe Breast Cancer-Related Lymphedema
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Benoit Chaput, Amélie Lusque, Julie Malloizel-Delaunay, Charlotte Chollet, Alexandra Yannoutsos, Barbara Garmy-Susini, Elodie Chantalat, Hélène Leray, Charlotte Vaysse, and Léonard Bouglon
- Subjects
Adult ,Oncology ,medicine.medical_specialty ,Breast Cancer Lymphedema ,Breast Neoplasms ,macromolecular substances ,030204 cardiovascular system & hematology ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Risk Factors ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Risk factor ,Mastectomy ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Middle Aged ,medicine.disease ,Obesity ,humanities ,body regions ,Lymphedema ,nervous system ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Breast Cancer Related Lymphedema - Abstract
Background: A few studies have examined the characteristics of severe breast cancer-related lymphedema (BCRL). This study aims at analyzing the factors associated with severe lymphedema (LE) across...
- Published
- 2020
24. Translation and Validation of the Turkish Version of Lymphedema Quality of Life Tool (LYMQOL) in Patients with Breast Cancer Related Lymphedema.
- Author
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Bakar, Yeşim, Tuğral, Alper, Özdemir, Özlem, Duygu, Elif, and Üyetürk, Ümmügül
- Subjects
- *
LYMPHEDEMA , *BREAST cancer surgery , *QUALITY of life , *BREAST cancer diagnosis , *BREAST cancer - Abstract
Objective: Breast cancer related lymphedema (BCRL) is a drastic situation that affects patients who have undergone breast cancer surgery. The impact of this condition on individuals' quality of life should be investigated in more detail to obtain better treatment results. Materials and Methods: In total, 65 patients with BCRL participated in this study. Nottingham Health Profile (NHP) was used to evaluate the validity of associated domains in Lymphedema Quality of Life Tool (LYMQoL). Both the LYMQoL and NHP were filled out by BCRL patients. To evaluate its test-retest reliability, the LYMQoL was subsequently performed seven days following its initial application. Measurement properties such as internal consistency, test-retest reliability, criterion validity and factor structure were tested. The internal consistency was assessed via Cronbach's alpha; test-retest reliability was assessed by the intra-class correlation coefficient (ICC). Results: Cronbach's alpha values ranged from 0.74 to 0.91 for the LYMQoL total and domain scores. Test-retest reliability was excellent (ICC=0.92-0.99). When the relation between LYMQoL and NHP was investigated, 'good' to 'very good' correlations were obtained (r=0.539- 0.643, p<0.05) for all domains of LYMQoL. Exploratory factor analyses demonstrated a four-factor structure. Conclusion: Turkish version of LYMQoL is a valid and reliable measurement tool to evaluate the quality of life in patients with BCRL. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
25. Quantifying the Impact of Axillary Surgery and Nodal Irradiation on Breast Cancer–Related Lymphedema and Local Tumor Control: Long-Term Results From a Prospective Screening Trial
- Author
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Laura Salama, Kayla M. Daniell, Tessa C Gillespie, Barbara L. Smith, George E. Naoum, Amy Shui, Alphonse G. Taghian, Loryn K Bucci, Alice Y. Ho, Sacha A. Roberts, and Cheryl L. Brunelle
- Subjects
Adult ,Cancer Research ,medicine.medical_specialty ,Breast Cancer Lymphedema ,Breast Neoplasms ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Young adult ,Prospective cohort study ,Lymph node ,Aged ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,Axillary surgery ,Radiotherapy ,business.industry ,Incidence ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Lymphedema ,Oncology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Lymph Nodes ,Radiology ,business ,Literatur Kommentiert ,Breast Cancer Related Lymphedema ,Cohort study - Abstract
PURPOSE To independently evaluate the impact of axillary surgery type and regional lymph node radiation (RLNR) on breast cancer–related lymphedema (BCRL) rates in patients with breast cancer. PATIENTS AND METHODS From 2005 to 2018, 1,815 patients with invasive breast cancer were enrolled in a lymphedema screening trial. Patients were divided into the following 4 groups according to axillary surgery approach: sentinel lymph node biopsy (SLNB) alone, SLNB+RLNR, axillary lymph node dissection (ALND) alone, and ALND+RLNR. A perometer was used to objectively assess limb volume. All patients received baseline preoperative and follow-up measurements after treatment. Lymphedema was defined as a ≥ 10% relative increase in arm volume arising > 3 months postoperatively. The primary end point was the BCRL rate across the groups. Secondary end points were 5-year locoregional control and disease-free-survival. RESULTS The cohort included 1,340 patients with SLNB alone, 121 with SLNB+RLNR, 91 with ALND alone, and 263 with ALND+RLNR. The overall median follow-up time after diagnosis was 52.7 months for the entire cohort. The 5-year cumulative incidence rates of BCRL were 30.1%, 24.9%, 10.7%, and 8.0% for ALND+RLNR, ALND alone, SLNB+RLNR, and SLNB alone, respectively. Multivariable Cox models adjusted for age, body mass index, surgery, and reconstruction type showed that the ALND-alone group had a significantly higher BCRL risk (hazard ratio [HR], 2.66; P = .02) compared with the SLNB+RLNR group. There was no significant difference in BCRL risk between the ALND+RLNR and ALND-alone groups (HR, 1.20; P = .49) and between the SLNB-alone and SLNB+RLNR groups (HR, 1.33; P = .44). The 5-year locoregional control rates were similar for the ALND+RLNR, ALND-alone, SLNB+RLNR, and SLNB-alone groups (2.8%, 3.8%, 0%, and 2.3%, respectively). CONCLUSION Although RLNR adds to the risk of lymphedema, the main risk factor is the type of axillary surgery used.
- Published
- 2020
26. Integrating Symptoms Into the Diagnostic Criteria for Breast Cancer–Related Lymphedema: Applying Results From a Prospective Surveillance Program
- Author
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Cheryl L. Brunelle, Tessa C Gillespie, Nora Horick, Sacha A. Roberts, Jamie M. Jacobs, Alphonse G. Taghian, George E. Naoum, and Kayla M. Daniell
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Adult ,medicine.medical_specialty ,Breast Neoplasms ,Physical Therapy, Sports Therapy and Rehabilitation ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Breast cancer ,Risk Factors ,hemic and lymphatic diseases ,Internal medicine ,Edema ,medicine ,Humans ,Lymphedema ,030212 general & internal medicine ,Symptom onset ,Longitudinal cohort ,Aged ,Original Research ,Aged, 80 and over ,Proportional hazards model ,business.industry ,Incidence (epidemiology) ,Organ Size ,Middle Aged ,medicine.disease ,Health Surveys ,humanities ,body regions ,Epidemiologic Studies ,030220 oncology & carcinogenesis ,Arm ,Disease Progression ,Female ,Symptom Assessment ,medicine.symptom ,business ,Breast Cancer Related Lymphedema - Abstract
Objective The objectives of this study were to determine whether patients reporting symptoms are more likely to develop lymphedema and to describe the temporal relationship between symptom onset and lymphedema. Methods This was a prospective longitudinal cohort study of 647 women treated for breast cancer and screened for lymphedema using arm volume measurements and subjective questionnaires (n = 647; 2284 questionnaires [median 3.5 per patient, range = 1–24]). Primary study outcome was lymphedema (relative volume change ≥10%). The Kaplan–Meier method was used to estimate cumulative lymphedema incidence. Cox proportional hazards models were used to assess the relationship between symptoms, other risk factors, and lymphedema. Results A total of 64 patients (9.9%) developed lymphedema. On multivariable analysis, patients reporting increased arm size (hazard ratio = 3.09, 95% CI = 1.62–5.89) were more likely to progress to lymphedema than those who did not report this symptom. Of those who developed lymphedema, 37 (58%) reported an increased arm size a median of 6.1 months before lymphedema onset (range = 68.6 months before to 50.2 months after lymphedema onset). Conclusion Patients at risk of lymphedema who report increased arm size might do so prior to lymphedema onset and are at 3 times the risk of lymphedema as patients not reporting this symptom. Even without objective or observable edema, these patients should be followed vigilantly and considered for early intervention. Symptoms should be incorporated into screening and diagnostic criteria for lymphedema. Impact This study shows that patients at risk for breast cancer–related lymphedema who report increased arm size should be considered at high risk for progression to lymphedema—even without edema on measurement or clinical examination—and should be followed vigilantly, with consideration of early intervention. Lay summary If you are at risk of lymphedema and you feel as though your arm size has increased, you might develop lymphedema, and you are at 3 times the risk of lymphedema as patients not reporting this symptom. Even without measurable or observable edema, you should be followed vigilantly and consider early intervention.
- Published
- 2020
27. Breast Cancer–Related Lymphedema: Personalized Plans of Care to Guide Survivorship
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Pamela L. Ostby, Pamela K. Ginex, and Allison B. Anbari
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medicine.medical_specialty ,business.industry ,medicine.disease ,humanities ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Lymphedema ,Oncology ,Acquired immunodeficiency syndrome (AIDS) ,030220 oncology & carcinogenesis ,Survivorship curve ,medicine ,030212 general & internal medicine ,Intensive care medicine ,business ,Breast Cancer Related Lymphedema - Abstract
To present and discuss care domains (oncologic, cardiometabolic, aging, behavioral, environmental) for clinicians when approaching care for a breast cancer survivor at risk for developing breast cancer–related lymphedema (BCRL), as well as survivors who have been diagnosed with BCRL. Assessment using each domain aids in decision-making, yet also identifies barriers to pursuing personalized care for survivors with BCRL. BCRL occurs from damage to the lymphatics during breast cancer treatment and occurs in approximately 20 to 40% of survivors. Prospective surveillance and early treatment for BCRL are supported in the literature; however, these approaches are frequently not used within evidence-based recommendations. The five domains can be used to develop a personalized plan of BCRL care. Barriers to pursuing personalized care for survivors with BCRL are identified. Future work in developing evidence-based recommendations is needed to guide clinicians and survivors during prospective surveillance, successful risk reduction, early diagnosis, and treatment of BCRL.
- Published
- 2020
28. Advances and current concepts in reconstructive surgery for breast cancer
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Cagri Cakmakoglu, Graham S. Schwarz, Demetrius M. Coombs, Rebecca Knackstedt, and Risal Djohan
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0301 basic medicine ,medicine.medical_specialty ,Reconstructive surgery ,Breast Implants ,medicine.medical_treatment ,Breast Neoplasms ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,law ,medicine ,Humans ,skin and connective tissue diseases ,Breast Implantation ,Anaplastic large-cell lymphoma ,Mastectomy ,business.industry ,Incidence ,General surgery ,Hematology ,medicine.disease ,030104 developmental biology ,Oncology ,Axillary Lymphadenectomy ,030220 oncology & carcinogenesis ,Breast implant ,Lymphoma, Large-Cell, Anaplastic ,Female ,Breast reconstruction ,business ,Breast Cancer Related Lymphedema - Abstract
In this article, we report on recent advancements in reconstructive care of the breast cancer patient. New developments in sensate breast reconstruction to help address the problem of numbness after mastectomy have emerged and show promise. Methods to restore lymphatic physiologic flow after axillary lymphadenectomy using supermicrosurgical techniques have begun to show benefit by reducing the short-term incidence of breast cancer related lymphedema (BRCL). Breast implant safety has received significant recent attention and we explore the emergence of BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma) and its implications for the breast cancer patient and their multidisciplinary care team.
- Published
- 2020
29. Breast Cancer–Related Lymphedema: Risk Factors, Screening, Management, and the Impact of Locoregional Treatment
- Author
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Cheryl L. Brunelle, Sarah A. McLaughlin, and Alphonse G. Taghian
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Axillary lymph nodes ,business.industry ,MEDLINE ,Breast Neoplasms ,medicine.disease ,Lymphedema ,Breast cancer ,medicine.anatomical_structure ,Risk Factors ,Internal medicine ,medicine ,Humans ,Mass Screening ,Female ,Adverse effect ,business ,Review Articles ,Body mass index ,Breast Cancer Related Lymphedema ,Mass screening - Abstract
Patients fear lymphedema as an unpredictable daily reminder of breast cancer treatment. The medical community has assumed for years that the development of breast cancer–related lymphedema (BCRL) stemmed solely from the primary surgical extirpation of the axillary lymph nodes. However, contemporary data suggest that BCRL development is multifactorial, influenced by multimodality locoregional and systemic treatment strategies and perhaps by the individual patient’s ability to form collateral lymphatic pathways after injury, as well as potentially modifiable risk factors such as body mass index (BMI). Understanding the interaction between comprehensive locoregional treatment strategies and their collective impact on overall survival and long-term adverse effects such as BCRL is critical to providing patients individualized treatment recommendations. Herein, we review important factors for the development, diagnosis, prevention, and treatment of BCRL that should be considered when determining the contemporary locoregional management of breast cancer.
- Published
- 2020
30. Knowledge and Self Care Practices for Women with Breast Cancer Related Lymphedema
- Author
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Manal Salah Hassan, Magda Abd El-Aziz, Basma El-Araby El-Feqi, and Yosreah Mohamed Mohamed
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Breast surgery ,medicine.disease ,humanities ,body regions ,Radiation therapy ,Breast cancer ,Lymphedema ,hemic and lymphatic diseases ,Family medicine ,Health care ,Structured interview ,Self care ,Medicine ,business ,Breast Cancer Related Lymphedema - Abstract
Background: Breast cancer related lymphedema represents a major complication of breast cancer treatment, impacting the quality of life of breast cancer survivors. Patients with lymphedema need to conduct lifelong self care activities to control the progression of swelling, manage lymphedema-associated symptom burden, and minimize long term negative outcomes. Aim: This study aimed to assess knowledge and self care practices of women with breast cancer related lymphedema. Study design: A descriptive study design was utilized to conduct this study. Setting: This study was conducted in the outpatient breast clinic at Oncology Center and Nuclear Medicine, affiliated to Ain Shams University Hospitals. Subjects: A purposive sample of 50 women newly diagnosed with breast cancer related lymphedema, post mastectomy, and treated with radiotherapy. Data collection tools: A structured interview questionnaire for women with breast cancer related lymphedema, and self care practices questionnaire. Results: The mean age of the studied women was 47.71±7.16, and about one fifth of them had satisfactory level of total knowledge regarding breast cancer related lymphedema, also; the minority of them had adequate level of total lymphedema self care practices. Moreover there is statistically significant difference between the self care practices of the studied women and their educational level. Conclusion: The majority of the studied women had unsatisfactory knowledge regarding breast cancer related lymphedema, and almost of them had inadequate lymphedema self care practices. Recommendations: Educational programs about lymphedema and risk reduction methods after the breast surgery are strongly needed. Also, continuous in service educational programs should be held for all the health care team working in breast cancer units. In addition, further researches are recommended to assess barriers to self care among patients with breast cancer related lymphedema.
- Published
- 2020
31. The effects of yoga on breast-cancer-related lymphedema: a systematic review
- Author
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Ausanee Wanchai and Jane M. Armer
- Subjects
Biopsychosocial model ,medicine.medical_specialty ,business.industry ,Health Policy ,Research methodology ,Public Health, Environmental and Occupational Health ,Psychological intervention ,Traditional therapy ,medicine.disease ,030205 complementary & alternative medicine ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Lymphedema ,030220 oncology & carcinogenesis ,Hatha yoga ,medicine ,Physical therapy ,General Earth and Planetary Sciences ,business ,Breast Cancer Related Lymphedema ,General Environmental Science - Abstract
PurposeBreast-cancer-related lymphedema (BCRL) is a negative condition that affects biopsychosocial aspects of patients treated with breast cancer. Yoga has been reported as one of the complementary and alternative approaches used by patients diagnosed with BCRL. The aim of this systematic review was to explore the effectiveness of yoga on BCRL.Design/methodology/approachA systematic literature was performed by searching existing papers from the electronic scientific databases. Five papers were exclusively examined. Four studies were conducted in women with BCRL, and one study was conducted with women at risk for BCRL.FindingsFour types of yoga were evaluated in relationship with BCRL, namely: the Satyananda Yoga tradition, the modified Hatha yoga, the aerobic yoga training and the Ashtanga-based yoga practices. Four of five included studies reported that decrease in arm volume was not reported for all yoga-type interventions. One study showed no significant evidence that yoga was associated with limb volume change in women at risk of BCRL. Similarly, three studies reported that the change-of-arm-volume measures were not significantly different between the yoga and the control groups or in the same group before and after the yoga program. One quasi-experimental study reported arm volume significantly decreased after attending the yoga program.Originality/valueThis review reported the importance of being aware that yoga is not shown to be an effective strategy for managing or preventing BCRL. However, quality of research methodology, small sample sizes and the limited number of related studies should be acknowledged. Until more rigorous studies are performed, yoga may continue to be used as a complement to traditional therapy under the supervision of certified trainers.
- Published
- 2020
32. The basics of ultrasound elastography for diagnosis, assessment, and staging breast cancer-related lymphedema: a systematic review of the literature
- Author
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Antonio J. Forte, Gabriela Cinotto, Daniel Boczar, Xiaona Lu, Oscar J. Manrique, Maria T Huayllani, Pedro Ciudad, and Sarah A. McLaughlin
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medicine.medical_specialty ,Ovid medline ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Strain imaging ,medicine.disease ,Lymphedema ,Breast cancer ,Ultrasound elastography ,medicine ,Surgery ,Elastography ,Radiology ,business ,Breast Cancer Related Lymphedema ,Review Article on Lymphedema - Abstract
Breast cancer-related lymphedema (BCRL) incidence has been increasing overtime. Currently, there is not a preferred imaging tool for diagnosis, staging, and assessment of the disease. We aim to review the use of ultrasound elastography (UE) in BCRL patients. A systematic review was performed by querying PubMed, EMBASE, Ovid Healthstar, and Ovid Medline databases for studies that evaluated the use of UE in BCRL. The keywords “elastography” AND “lymphedema” in titles and abstracts were used for the search. The search retrieved 12, 12, 5 and 6 articles in each database, respectively. From these, only 4 met the inclusion criteria. UE methods included two-dimensional strain imaging, shear wave elastography (SWE), and global UE. Two of the studies evaluated the use of UE in the assessment of BCRL, while only 1 considered its use for diagnosis and staging. Based on our systematic review, UE appears to be a great tool in the assessment of BCRL to differentiate affected from non-affected arms.
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- 2020
33. Comparison of real-time ultrasound imaging for manual lymphatic drainage on breast cancer-related lymphedema in individuals with breast cancer: a preliminary study
- Author
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Seungwon Lee, Wonjae Choi, and Dong-Kwon Seo
- Subjects
medicine.medical_specialty ,business.industry ,Sequela ,Real time ultrasound ,medicine.disease ,Breast Cancer Lymphedema ,humanities ,body regions ,Lymphedema ,Manual lymphatic drainage ,Breast cancer ,hemic and lymphatic diseases ,medicine ,Radiology ,Ultrasonography ,skin and connective tissue diseases ,business ,Breast Cancer Related Lymphedema - Abstract
Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage...
- Published
- 2020
34. Evaluation of Vitamin D Levels in Patients with Breast Cancer-related Lymphedema: An Observational Cross-sectional Study
- Author
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Belma Füsun Köseoğlu, Sibel Ünsal Delialioğlu, Serhat Ergül, Meltem Dalyan, and Didem Sezgin Özcan
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Cross-sectional study ,Endocrinology, Diabetes and Metabolism ,lcsh:R ,lcsh:Medicine ,vitamin d ,lcsh:Other systems of medicine ,lymphedema ,medicine.disease ,lcsh:RZ201-999 ,humanities ,parathormone ,Lymphedema ,Breast cancer ,breast cancer ,Internal medicine ,Vitamin D and neurology ,Medicine ,In patient ,Observational study ,business ,Breast Cancer Related Lymphedema - Abstract
Objective: The aim of our study was to compare plasma vitamin D levels between patients with breast cancer-related lymphedema (BCRL) and healthy population, and also to investigate the effects of socio-demographic and clinical factors and lymphedema severity on vitamin D levels. Materials and Methods: Eighty patients with BCRL [mean age 55.5 +/- 8.9 (36-81)] and age- and sex-matched 80 healthy controls [mean age 53.7 +/- 7.4 (32-70)] who were not on calcium or vitamin D supplementation were included in the study. Socio-demographic and clinical characteristics of the subjects were questioned. Plasma 25-Hydroxyvitamin D3, calcium, phosphorus, alkaline phosphatase (ALP), and parathormone (PTH) levels were evaluated. Lymphedema was classified as stage 0, I, II, or III. Results: The mean duration of lymphedema was 23.5 +/- 13.8 months. Comparisons revealed lower vitamin D levels and higher PTH and ALP levels in patients with BCRL than healthy controls. As a result of multivariate regression analysis, a significant relationship was revealed between vitamin D levels and age, breast cancer stage, and disease duration in patients with BCRL. Vitamin D levels were significantly lower and PTH levels were significantly higher in stage 3 lymphedema patients compared to stage 1. Conclusion: Vitamin D levels were detected lower in patients with lymphedema than healthy controls. Although vitamin D levels were found to be lower in patients with severe lymphedema, the multivariate regression analysis revealed that the severity of lymphedema does not have a significant effect on vitamin D levels.
- Published
- 2019
35. Noninvasive Measurements of Breast Cancer-Related Lymphedema
- Author
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Harvey N. Mayrovitz
- Subjects
Oncology ,medicine.medical_specialty ,Physical Medicine & Rehabilitation ,business.industry ,General Engineering ,water displacement ,breast cancer ,limb volumes ,General Surgery ,tissue dielectric constant ,Internal medicine ,edema measurement ,impedance ,medicine ,measuring lymphedema ,business ,Breast Cancer Related Lymphedema - Abstract
Breast cancer-related lymphedema (BCRL) presents as swelling in the arm, hand, trunk, or breast at varying times after completion of breast cancer treatment. Its reported incidence varies widely in part due to its dependence on the type and extent of the treatment, co-present pre-treatment risk factors, and the criteria used to define its presence. Central to this issue is the quantitative measures that are variously used to specify lymphedema thresholds for its detection and tracking over time and during treatment. The goal of this paper is to discuss these issues and the methods available for the non-invasive quantitative assessment of BCRL. Operational principles and advantages and limitations of the various methods and their clinical history of use and effectiveness are discussed.
- Published
- 2021
36. Lymphedema Index Ratio As Predictive Factor of Treatment in Patients with Breast Cancer-Related Lymphedema
- Author
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Ho Joong Jeong, Yeong Kyun Bae, Young Joo Sim, Han Eum Choi, Jae Hyun Lee, and Ghi Chan Kim
- Subjects
Oncology ,medicine.medical_specialty ,Complex decongestive therapy ,Breast Cancer Lymphedema ,Breast Neoplasms ,Breast cancer ,Internal medicine ,medicine ,Humans ,In patient ,Lymphedema ,Retrospective Studies ,Massage ,business.industry ,Retrospective cohort study ,medicine.disease ,humanities ,Predictive factor ,body regions ,Treatment Outcome ,Female ,Cardiology and Cardiovascular Medicine ,business ,Bioelectrical impedance analysis ,Breast Cancer Related Lymphedema - Abstract
Background: This retrospective observational study aimed to evaluate the lymphedema index ratio to predict the effect of complex decongestive therapy (CDT) in patients with breast cancer-related ly...
- Published
- 2021
37. Immediate Lymphatic Reconstruction to Prevent Breast Cancer-Related Lymphedema: A Systematic Review
- Author
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Mithun Sinha, Aladdin H. Hassanein, Carla S. Fisher, Mary Lester, Chandan K. Sen, and Julia A. Cook
- Subjects
medicine.medical_specialty ,Breast Cancer Lymphedema ,Breast Neoplasms ,Anastomosis ,Critical Care and Intensive Care Medicine ,Breast cancer ,hemic and lymphatic diseases ,Medicine ,Humans ,Lymphedema ,Lymph node ,business.industry ,Axillary Lymph Node Dissection ,medicine.disease ,humanities ,Surgery ,body regions ,Dissection ,Lymphatic system ,medicine.anatomical_structure ,Axilla ,Emergency Medicine ,Quality of Life ,Female ,business ,Breast Cancer Related Lymphedema - Abstract
SIGNIFICANCE Lymphedema is chronic limb swelling from lymphatic dysfunction. The condition affects up to 250 million people worldwide. In breast cancer patients, lymphedema occurs in 30% who undergo axillary lymph node dissection (ALND). Recent Advances: Immediate lymphatic reconstruction (ILR), also termed Lymphatic Microsurgical Preventing Healing Approach (LyMPHA), is a method to decrease the risk of lymphedema by performing prophylactic lymphovenous anastomoses at the time of ALND. The objective of this study is to assess the risk reduction of ILR in preventing lymphedema. CRITICAL ISSUES Lymphedema has significant effects on the quality of life and morbidity of patients. Several techniques have been described to manage lymphedema after development, but prophylactic treatment of lymphedema with ILR may decrease risk of development to 6.6%. FUTURE DIRECTIONS Long-term studies that demonstrate efficacy of ILR may allow for prophylactic management of lymphedema in the patient undergoing lymph node dissection. .
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- 2021
38. Indocyanine green lymphangiography is superior to clinical staging in breast cancer-related lymphedema
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Mads Gustaf Jørgensen, Anette Riis Madsen, Steffanie Christensen, Anne Pernille Hermann, and Jens Ahm Sørensen
- Subjects
Indocyanine Green ,medicine.medical_specialty ,Science ,Breast Cancer Lymphedema ,Clinical exam ,Breast Neoplasms ,Article ,chemistry.chemical_compound ,Breast cancer ,Absorptiometry, Photon ,Physical examination ,Diagnosis ,medicine ,Humans ,Stage (cooking) ,Aged ,Multidisciplinary ,business.industry ,Significant difference ,Confounding ,Lymphography ,Middle Aged ,medicine.disease ,Lymphedema ,chemistry ,Lean body mass ,Medicine ,Female ,Radiology ,business ,Indocyanine green ,Breast Cancer Related Lymphedema - Abstract
Precise staging of breast cancer-related lymphedema (BCRL) is important to guide treatment-decision making. Recent studies have suggested staging of BCRL using indocyanine green lymphangiography (ICG-L) based on the extent of lymphatic injury and dermal backflow patterns. Currently, the benefits of ICG-L compared to conventional clinical staging are unknown. For this study, we included 200 patients with unilateral BCRL. All BCRL patients were staged using ICG-L and clinical exam. The amounts of excess arm volume, fat mass and lean mass were compared between stages using Dual Energy X-Ray Absorptiometry. Multivariate regression models were used to adjust for confounders. For each increase in the patient's ICG-L stage, the excess arm volume, fat mass and lean mass was increased by 8, 12 and 6.5 percentage points respectively (P P
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- 2021
39. Self-management Strategies for Risk Reduction of Subclinical and Mild Stage of Breast Cancer-Related Lymphedema: A Longitudinal, Quasi-experimental Study
- Author
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Yingxin Wang, Quanping Zhao, Fei Liu, Fenglian Li, Dong Pang, Sanli Jin, Qian Lu, Ping Yang, and Mei R. Fu
- Subjects
medicine.medical_specialty ,Self-management ,Oncology (nursing) ,business.industry ,Self-Management ,Breast Neoplasms ,medicine.disease ,humanities ,body regions ,Breast cancer ,Lymphedema ,Oncology ,hemic and lymphatic diseases ,Internal medicine ,Quasi experimental study ,medicine ,Humans ,Female ,Stage (cooking) ,business ,Generalized estimating equation ,Risk Reduction Behavior ,Breast Cancer Related Lymphedema ,Subclinical infection - Abstract
BACKGROUND Early intervention with self-management strategies can potentially reduce the risk of progression of breast cancer-related lymphedema (BCRL). OBJECTIVE To determine if The-Optimal-Lymph-Flow (TOLF) program focused on self-management strategies applied to patients with a subclinical or mild stage of BCRL can improve lymphedema-related behaviors, symptom experience, and limb circumference changes. METHODS A total of 41 women with subclinical or mild lymphedema were enrolled in TOLF program. Lymphedema-related behaviors and lymphedema-related symptom experiences were measured by the Breast Cancer and Lymphedema Symptom Experience Index, and limb circumference changes were measured by sequential circumferential limb measurements at baseline and 1, 3, 6, and 12 months after the intervention. Generalized estimating equations were used to estimate the effects of the intervention on outcomes. RESULTS Generalized estimating equations revealed that lymphedema-related behaviors and the number and severity of lymphedema-related symptoms were significantly improved at 4 postintervention test points compared with baseline (all P < .001). Reduced lymphedema-related symptom distress in functional, social, emotional, and psychological and self-perception (all P < .01) also resulted. The majority (77.5%) of patients maintained their preintervention lymphedema status; 17.5% of them reversed from mild lymphedema to subclinical lymphedema; 5.0% of them had lymphedema status progression. CONCLUSION Positive outcomes in terms of lymphedema-related behaviors, relieving lymphedema-related symptom experience, and halting the progression of lymphedema status were documented following TOLF. IMPLICATIONS FOR PRACTICE Nurses could educate patients to incorporate the self-management strategies of TOLF program into daily life to help patients prevent or reverse subclinical or mild stage of BCRL.
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- 2021
40. Evaluating the Quality of Life and Sleep Quality in Saudi Women with Breast Cancer-Related Lymphedema: A Cross-Sectional Correlational Study
- Author
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Walid Kamal Abdelbasset, H I Alrebdi, K.S. Almugren, Nissren Tamam, and Abdelmoneim Sulieman
- Subjects
Pediatrics ,medicine.medical_specialty ,Saudi Arabia ,Breast Neoplasms ,quality of sleep ,Breast cancer ,breast cancer ,Quality of life ,hemic and lymphatic diseases ,Medicine ,Humans ,Lymphedema ,RC254-282 ,Sleep quality ,business.industry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Sleep in non-human animals ,humanities ,body regions ,Cross-Sectional Studies ,Complementary and alternative medicine ,Oncology ,Correlational study ,quality of life ,Female ,business ,Complication ,Sleep ,Breast Cancer Related Lymphedema ,Research Article - Abstract
Background Among the different cancers found in women, breast cancer is the most common. Breast cancer-related lymphedema is a serious health complication affecting the quality of life and sleep quality. This study evaluates the quality of life and sleep quality among Saudi women with different stages of lymphedema following the treatment of breast cancer. Methods This cross-sectional correlational study included 163 Saudi women with breast cancer-related lymphedema (Stages I-III), aged 28 to 56 years. From the patients identified for this study, women who suffered from mental and psychological dysfunctions or other malignant disorders were excluded. Copies of structured questionnaires were given to each participant during their visits to outpatient physiotherapy clinics. Quality of life was assessed using a valid questionnaire (EORTC QLQ-C30), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The differences between the different lymphedema stages have been assessed. Results Of the total number of participants 27 women had been diagnosed with stage I lymphedema, 84 women had been diagnosed with stage II lymphedema, and 52 women had been diagnosed with stage III lymphedema. All participants have shown low scores on both EORTC QLQ-C30 and PSQI. While analyzing the differences between the 3 stages of lymphedema with the Kruskal–Wallis test, noteworthy statistical differences between the 3 stages of lymphedema ( P Conclusion and Recommendations Both quality of life and quality of sleep have significantly decreased in Saudi women with different stages of breast cancer-related lymphedema. Quality of life and quality of sleep are the worst in stage III lymphedema patients. Future research should consider repeat and enlarge these results as well as assess the risk factors that affect the quality of life and quality of sleep among Saudi women suffering from breast cancer-related lymphedema.
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- 2021
41. The Interrater Reliability of the Scoring of the Lymphatic Architecture and Transport Through Near-InfraRed Fluorescence Lymphatic Imaging in Patients with Breast Cancer-Related Lymphedema
- Author
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Inge Fourneau, Sarah Thomis, Jantine Kleiman, An-Kathleen Heroes, Nele Devoogdt, Tessa De Vrieze, and Melissa Helberg
- Subjects
medicine.medical_specialty ,Physiology ,Breast Cancer Lymphedema ,lymphatic system ,Breast Neoplasms ,Near infrared fluorescence ,030204 cardiovascular system & hematology ,Research & Experimental Medicine ,Lymphatic System ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,lymphofluoroscopy ,medicine ,breast neoplasms ,interrater reliability ,Humans ,In patient ,Lymphedema ,Lymphatic Vessels ,Science & Technology ,business.industry ,near infrared fluorescence ,Reproducibility of Results ,lymphedema ,medicine.disease ,Lymphatic system ,Medicine, Research & Experimental ,030220 oncology & carcinogenesis ,INDOCYANINE GREEN LYMPHOGRAPHY ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,diagnosing ,Life Sciences & Biomedicine ,Breast Cancer Related Lymphedema - Abstract
Background: Of the 1.38 million women who are diagnosed every year with breast cancer worldwide, 21% will develop arm lymphedema. Near-infrared fluorescence lymphatic imaging (NIRFLI) is an effective method for real-time evaluation of the lymphatic system. Reliability studies of the scoring of this NIRFLI are lacking. The aim of this study is to investigate if evaluation of the superficial lymphatic architecture and transport in patients with breast cancer-related lymphedema through NIRFLI can be performed in a reliable way. Methods and Results: The outcome parameters used to assess agreement were the presence of lymphatic transport from the injection sites, of dermal backflow patterns, of efferent lymphatic vessels, and of lymph nodes. The NIRFLI evaluations were scored before and after a break separately by two assessors. Twenty patients with lymphedema of the arm and/or hand were included. After the injection, there was weak to very strong agreement regarding the presence of transport from the injection sites (K = 0.459-1.000). The interpretation of the type of dermal backflow pattern varied from weak (WK = 0.452) to very strong agreement (WK = 1.000) between the two assessors. Agreement in the visualization of efferent lymphatic vessels was weak before and after the break (K = 0.490 and K = 0.571) and agreement regarding the presence of lymph nodes was very strong (K = 1.000). Conclusion: Overall, there was moderate to strong agreement between the assessors when evaluating the lymphatic architecture and transport through NIRFLI. The study has been registered at clinicaltrials.gov (NCT02609724). ispartof: LYMPHATIC RESEARCH AND BIOLOGY vol:20 issue:2 pages:133-143 ispartof: location:United States status: published
- Published
- 2021
42. Interrater and Intrarater Reliability of Subcutaneous Echogenicity Grade and Subcutaneous Echo-Free Space Grade in Breast Cancer-Related Lymphedema
- Author
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Esra Giray and Ilker Yagci
- Subjects
Adult ,medicine.medical_specialty ,Breast Cancer Lymphedema ,Breast Neoplasms ,Sensitivity and Specificity ,Severity of Illness Index ,Subcutaneous Tissue ,Breast cancer ,medicine ,Humans ,Ultrasonography ,Observer Variation ,business.industry ,Ultrasound ,Reproducibility of Results ,Echogenicity ,Intra-rater reliability ,Free space ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Lymphedema ,medicine.anatomical_structure ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Breast Cancer Related Lymphedema ,Subcutaneous tissue - Abstract
Background: Subcutaneous echogenicity grade (SEG) and subcutaneous echo-free space (SEFS) grade allow semiquantitation of nonspecific subcutaneous tissue inflammation and fluid accumulatio...
- Published
- 2019
43. Optimizing Patient Positioning to Reduce Variation in the Measurement of Breast Cancer-Related Lymphedema
- Author
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Marigold L Travis, Thomas A. Buchholz, Parviz Kheirkhah, Isabelle Bedrosian, Mark V. Schaverien, Sarah M. DeSnyder, Susan Lilly, and Simona F. Shaitelman
- Subjects
medicine.medical_specialty ,Anthropometry ,business.industry ,Breast Cancer Lymphedema ,Reproducibility of Results ,Patient positioning ,Organ Size ,030204 cardiovascular system & hematology ,medicine.disease ,Patient Positioning ,Volume measurements ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Lymphedema ,030220 oncology & carcinogenesis ,Arm ,medicine ,Humans ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Breast Cancer Related Lymphedema - Abstract
Background: Prospective lymphedema screening is recommended for breast cancer patients. We observed interoperator variation in perometer-acquired arm volume measurements (P-AVMs) due to pa...
- Published
- 2019
44. A nurse’s twenty-four-year journey with breast cancer-related lymphedema
- Author
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Jane M. Armer and Yuanlu Sun
- Subjects
Work activity ,media_common.quotation_subject ,Nurses ,Breast Neoplasms ,Midwestern United States ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Breast cancer ,Nursing ,Surveys and Questionnaires ,medicine ,Humans ,Disease process ,Lymphedema ,Survivors ,Major complication ,Qualitative Research ,media_common ,business.industry ,Rehabilitation ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,030210 environmental & occupational health ,Feeling ,030220 oncology & carcinogenesis ,Female ,business ,Breast Cancer Related Lymphedema ,Qualitative research - Abstract
Background Lymphedema is one of the major complications following breast cancer treatment. The majority of women who develop breast cancer are in their years of employment. Occupational functioning and employment are issues of significant concern among women with breast cancer-related lymphedema (BCRL). We present a single-case study of a nurse living with BCRL for more than two decades in the Midwestern United States, as an exemplar to explore the 'return-to-work' phenomenon. Methods A sixty-minute, semi-structured interview was conducted with a selected single case ("Linda"), following a pre-interview survey. Themes and sub-concepts were generated through constant-comparison of evidence within the case. Results Themes included: the feeling of being lost, functional impairments related to BCRL and bandaging, being limited yet not being limited, and experiencing different challenges with different jobs. Overall, returning to work with BCRL was a complex phenomenon involving interactions of the disease process, the work activity, the individual, and an array of contextual factors. Conclusions Linda's struggles, efforts, and adaptations at different career points were revealing and exemplified how individuals navigate the journey of returning to work with BCRL.
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- 2019
45. Impact of breast cancer–related lymphedema on working women
- Author
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Fabrice Locher, Laura E. Simon, M.-L. Sanchez-Bréchot, Pascal Fau-Prudhomot, Maria Arrault, and Stéphane Vignes
- Subjects
Univariate analysis ,medicine.medical_specialty ,Multivariate analysis ,business.industry ,Occupational physicians ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,medicine.anatomical_structure ,Lymphedema ,Oncology ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Upper limb ,030212 general & internal medicine ,Occupational activity ,business ,Breast Cancer Related Lymphedema - Abstract
The professional impact of upper limb lymphedema, which affects 15–20% of women after breast cancer treatment, has been poorly evaluated. To analyze lymphedema characteristics and global lymphedema- and/or sleeve-attributed impact (mildly inconvenient to severely debilitating) on professional activities, workplace relationships, and workstation ergonomics. Patients received a standardized, anonymous, self-administered questionnaire at consultation/hospitalization for treatment in a specialized lymphedema management center. All 134 consecutive women (March/2015–March/2017; median age 54), with 53-month median lymphedema duration and 34% median excess volume, were included; 35% considered global impact (arm-use impairment) high. For high vs. low global impact during occupational activities, univariate analyses identified global impairment as being associated with the low (23.8%), intermediate (60%), or high (63.2%) (p
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- 2019
46. Diagnostic Significance of Fibrin Degradation Products and D-Dimer in Patients With Breast Cancer-Related Lymphedema
- Author
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Ryu, Sang Hyeong, Min, Sang Won, Kim, Jae Ho, Jeong, Ho Joong, Kim, Ghi Chan, Kim, Dong Kyu, and Sim, Young-Joo
- Subjects
medicine.medical_specialty ,Deep vein ,lcsh:Medicine ,Breast cancer related lymphedema ,Gastroenterology ,Fibrin ,Breast cancer ,Internal medicine ,Deep vein thrombosis ,D-dimer ,medicine ,In patient ,Fibrin degradation products ,biology ,business.industry ,Rehabilitation ,lcsh:R ,medicine.disease ,Thrombosis ,Venous thrombosis ,Lymphedema ,medicine.anatomical_structure ,biology.protein ,Original Article ,business - Abstract
Objective To find out whether levels of fibrin degradation products (FDP) and D-dimer are increased in breast cancer-related lymphedema (BCRL) as in many vascular diseases. FDP and D-dimer have been used in blood tests to help differentiate deep vein thrombosis in the diagnosis of lymphedema. Levels of FDP and D-dimer are often elevated in patients with BCRL. Methods Patients with BCRL (group I), non-lymphedema after breast cancer treatment (group II), and deep venous thrombosis (group III) from January 2012 to December 2016 were enrolled. Levels of FDP and D-dimer were measured in all groups and compared among groups. Results Mean values of FDP and D-dimer of group I were 5.614±12.387 and 1.179±2.408 μg/μL, respectively. These were significantly higher than their upper normal limits set in our institution. Levels of FDP or D-dimer were not significantly different between group I and group II. However, values of FDP and D-dimer in group III were significantly higher than those in group I. Conclusion Values of FDP and D-dimer were much higher in patients with thrombotic disease than those in patients with lymphedema. Thus, FDP and D-dimer can be used to differentiate between DVT and lymphedema. However, elevated levels of FDP or D-dimer cannot indicate the occurrence of lymphedema.
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- 2019
47. Correlation of Bioimpedance Spectroscopy with Risk Factors for the Development of Breast Cancer-Related Lymphedema
- Author
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Michael Walker, Chirag Shah, Frank A. Vicini, Jing Shi, and Pat Whitworth
- Subjects
Oncology ,Adult ,medicine.medical_specialty ,Breast Cancer Lymphedema ,Antineoplastic Agents ,Breast Neoplasms ,Body Mass Index ,Correlation ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,breast cancer ,Bioimpedance spectroscopy ,Risk Factors ,Internal medicine ,bioimpedance ,medicine ,polycyclic compounds ,Humans ,030212 general & internal medicine ,Prospective Studies ,skin and connective tissue diseases ,Aged ,Analysis of Variance ,business.industry ,Sentinel Lymph Node Biopsy ,Original Articles ,lymphedema ,Middle Aged ,medicine.disease ,Lymphedema ,Gamma Rays ,030220 oncology & carcinogenesis ,Dielectric Spectroscopy ,Lymph Node Excision ,Female ,Taxoids ,sense organs ,Cardiology and Cardiovascular Medicine ,business ,Breast Cancer Related Lymphedema ,hormones, hormone substitutes, and hormone antagonists - Abstract
Background: We reviewed serial bioimpedance measurements in order to quantify the relationship between changes in these scores and a patient's risk for developing breast cancer-related lymphedema (BCRL). Methods and Results: From April 2010 through November 2016, 505 patients were prospectively evaluated using bioimpedance spectroscopy (BIS/L-Dex). Patients received preoperative and postoperative L-Dex measurements and were categorized based upon risk for BCRL with respect to axillary staging procedure, radiation use, taxane use, and body mass index (BMI). L-Dex change was associated with the type and number of BCRL risk factors. Both axillary lymph node dissection (ALND) and regional nodal irradiation (RNI) were associated with a greater change in L-Dex (p
- Published
- 2018
48. Prospective Validation of Indocyanine Green Lymphangiography Staging of Breast Cancer-Related Lymphedema
- Author
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Jens Ahm Sørensen, Frederik Christopher Gulmark Hansen, Jørn Bo Thomsen, Mads Gustaf Jørgensen, and Navid Mohamadpour Toyserkani
- Subjects
Cancer Research ,medicine.medical_specialty ,indocyanine green ,genetic structures ,030230 surgery ,lcsh:RC254-282 ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Breast cancer ,breast cancer ,medicine ,Clinical severity ,Lymphedema ,Stage (cooking) ,lymphangiography ,business.industry ,observer ,lymphedema ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Observer ,Indocyanine green ,eye diseases ,body regions ,Inter-rater reliability ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Lymphangiography ,Radiology ,business ,Kappa ,Breast Cancer Related Lymphedema - Abstract
Indocyanine green lymphangiography (ICG-L) allows real-time investigation of lymphatics. Plastic surgeons performing lymphatic reconstruction use the ICG-L for patient selection and stratification using the MD Anderson (MDA) and the Arm Dermal Backflow (ADB) grading systems. However, the applicability of ICG-L in evaluating breast cancer-related lymphedema (BCRL) is sparse and not well established. This study comprehensively examines the usability of ICG-L in the assessment of BCRL. We prospectively performed ICG-L in 237 BCRL patients between January 2019 and February 2020. The aim of this study was to assess the interrater and intrarater agreement and interscale consensus of ratings made using the MDA and ADB scales. Three independent raters performed a total of 2607 ICG-L assessments. The ICG-L stage for each grading system was correlated to the lymphedema volume to assess the agreement between the ICG-L stage and clinical severity. The interrater agreement was near perfect for the MDA scale (kappa 0.82–0.90) and the ADB scale (kappa 0.80–0.91). Similarly, we found a near-perfect intrarater agreement for the MDA scale (kappa 0.84–0.94) and the ADB scale (kappa 0.88–0.89). The agreement between the MDA and the ADB scales was substantial (kappa 0.65–0.68), however, the ADB scale systematically overestimated lower ICG-L stages compared to the MDA scale. The volume of lymphedema correlated slightly with MDA stage (Spearmans rho = 0.44, p <, 0.001) and ADB stage (rs = 0.35, p <, 0.001). No serious adverse events occurred. The staging of BCRL with ICG-L is reliable, safe, and provides unique disease information unobtainable with clinical measurements alone. The MDA scale seems to provide better disease stratification compared to the ADB scale.
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- 2021
49. Predictors of Quality of Life in Patients with Breast Cancer-Related Lymphedema: Effect of Age, Lymphedema Severity, and Anxiety
- Author
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Qiaoling Zhong, Qinghua Luo, Huiting Zhang, Huizhen Zhang, Hui-Ying Qin, Ni Gong, Lijuan Zhang, and Yiheng Zhang
- Subjects
Oncology ,medicine.medical_specialty ,Breast Cancer Lymphedema ,Breast Neoplasms ,macromolecular substances ,030230 surgery ,Anxiety ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Quality of life ,hemic and lymphatic diseases ,Internal medicine ,Medicine ,Humans ,In patient ,Lymphedema ,Depression (differential diagnoses) ,business.industry ,medicine.disease ,humanities ,body regions ,Cross-Sectional Studies ,030220 oncology & carcinogenesis ,Quality of Life ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Breast Cancer Related Lymphedema - Abstract
Background: Patients with breast cancer-related lymphedema (BCRL) have lower quality of life (QOL). However, some important predictors, such as the effect of age, lymphedema severity, depression, a...
- Published
- 2021
50. Effectiveness of elastic lymph tapes in the treatment of secondary lymphedema in patients after breast cancer treatment
- Author
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Schuh, Cornelia
- Subjects
breast cancer ,brustkrebsassoziiertes Lymphödem ,Reduktion ,breast cancer related lymphedema ,elastisches Lymphtape ,Brustkrebs ,lymphtape ,reduction - Abstract
Hintergrund: Brustkrebs ist die häufigste Krebserkrankung bei Frauen. Die Betroffenen werden mit einer Kombination aus Operation, Chemotherapie und Strahlentherapie behandelt. Besonders die axilläre Lymphknotendissektion und die Bestrahlung der axillären Lymphknoten sind behandlungsbedingte Risikofaktoren für ein Lymphödem. Auch wenn ein Lymphödem keinen lebensbedrohlichen Zustand darstellt, handelt es sich um eine chronische Erkrankung. Sie führt zu erheblichen Einschränkungen und wiederkehrenden Infektionen der Extremität. Neben der Standardbehandlung mit manueller Lymphdrainage, Kompression und therapeutischen Übungen werden immer häufiger elastische Lymphtapes zur Behandlung eingesetzt. Ziel dieser Arbeit ist es anhand von klinischen Studien, den Effekt von elastischen Lymphtapes (in Bezug auf Armvolumen und Armumfang) bei Patientinnen mit Lymphödem nach einem Mammakarzinom aufzuzeigen. Methode: Dazu wurde eine Literaturrecherche in den Datenbanken PubMed, PEDro und Cochrane Library durchgeführt. Fünf passende Studien wurden für diese Arbeit ausgewählt. Ergebnisse: Alle fünf Studien zeigen, dass elastische Lymphtapes eine effektive Behandlungsmöglichkeit von sekundären Lymphödemen sein können. Sowohl Armvolumen und Armumfang als auch brustkrebsassoziierte Symptome konnten verringert werden. Drei der Arbeiten schreiben dem Tape besser Ergebnisse zu als der Behandlung mit Kompressionskleidung oder Bandagen. KT ist im Vergleich zur Standardbehandlung mit Kompression von den Teilnehmerinnen als angenehmer empfunden worden. Eine Studie untersuchte mit der Anlage von Quasi-KT einen möglichen Placebo-Effekt. Die Ergebnisse waren in der Quasi-KT und der KT-Gruppe ähnlich groß. Schlussfolgerung: Es lässt sich sagen, dass KT eine Alternative zur Standardbehandlung darstellt. Zudem ist die Akzeptanz bei Patientinnen mit Tapes höher als bei Standardbehandlungen mit Bandagen oder Kompressionskleidung. Background: Breast cancer is the most common cancer in women. Affected women are treated with a combination of surgery, chemotherapy, and radiation therapy. In particular, axillary lymph node dissection and irradiation of the axillary lymph nodes are treatment-related risk factors for lymphedema. Even if a lymphedema is not a life-threatening condition, it is a chronic disease. It leads to considerable restrictions and recurring infections of the extremities. In addition to the standard treatment with manual lymphatic drainage, compression and therapeutic exercises, elastic lymphatic tapes are increasingly being used for treatment. The aim of this work is to use clinical studies to show the effect of elastic lymph tapes in relation to arm volume and arm circumference of patients with lymphedema after breast cancer. Method: A literature search in the PubMed, PEDro and Cochrane Library databases was carried out. Five matching studies were selected for this work. Results: All five studies show, that elastic lymph tapes can be an effective treatment for secondary lymphedema. Arm volume or arm circumference as well as breast cancer-associated symptoms could be reduced. Three of the papers attribute better results to the tape than to treatment with compression garment or bandages. In comparison to the standard treatment with compression, KT was found to be more pleasant for the participants. A study examined a possible placebo effect with the installation of Quasi-KT. The results of the quasi-KT were similar to the KT group. Conclusion: It can be said that KT is an alternative to standard treatment. In addition, the acceptance of tapes is higher than the acceptance of standard treatments with bandages or compression clothing.
- Published
- 2021
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