Lymphoedema Following Regional Lymph Node Surgery for Breast Cancer

Česká verzia

Authors: P. Vrtělová ¹; O. Coufal ^1,2 ; V. Fait ^1,2; L. Gabrielová ¹; O. Zapletal ¹
Authors place of work: Klinika operační onkologie, Masarykův onkologický ústav, Brno ¹; Lékařská fakulta MU, Brno ²
Published in the journal: Klin Onkol 2017; 30(1): 34-40
Category: Přehled
doi: https://doi.org/10.14735/amko201734

Summary

Background:
The treatment of breast cancer is based on the multimodal principle and surgery of regional lymph nodes is an inseparable part of this. Indication criteria are changing constantly folowing advances in other modalities. It is necessary to consider not only the diagnostic or therapeutic benefit but also to take into account adverse effects. Previous studies have demonstrated that axillary dissection (ALND) is burdened by a high frequency of chronic lymphoedema of the arm or chest wall; however, a considerable percentage of patients may also suffer from lymphoedema after sentinel lymph node biopsy (SLNB).

Aim:
This paper focuses on the pathophysiology of lymphoedema, its potential predictive factors, and its complications. Furthermore, it presents an overview of published studies comparing the incidences of lymphoedema after current axillary surgery for breast cancer together with current trends designed to radically reduce the number of these operations. It also briefly refers to the possibilities of implementing preventive or therapeutic operations for lymphoedema.

Conclusions:
Both ALND and SLNB are burdened by a clinically significant risk of lymphoedema. This risk is more serious after ALND. In the medium term, approximately 7–59% of operated patients suffer from lymphoedema. The incidence of lymphoedema after SLNB, considered a very gentle method, is also not negligible (0–14%). As the number of patients surviving breast cancer treatment continues to increase, monitoring the undesirable effects of axillary surgery over the long term will become more important. The results of published studies support research into treatment methods that have the potential to reduce the radicality of axillary surgery while preserving or improving total medical effectiveness.

Key words:
breast neoplasms – sentinel lymph node biopsy – axillary dissection – adverse effects – breast cancer lymphedema

This work was supported by the grants MEYS – NPS I – LO1413 and MH CZ – DRO (MMCI, 00209- 805).

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
7. 11. 2016

Accepted:
5. 12. 2016

Zdroje

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