الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Lymphedema is a swelling that occurs when protein-rich lymph fluid accumulates in
the interstitial tissue.This lymph fluid may contain plasma proteins, extravascular blood
cells, excess water, and parenchymal products.
Lymphedema is an important consideration for clinicians who care for cancer breast
patients because of its relatively high frequency and significant functional and quality of
life implications for patients. Lymphedema is an independent predictor of decreased
quality of life, even when other predictive factors such as socioeconomic status, decreased
range of motion, age, and obesity are taken into account.
The overall incidence is approximately 25 % , but ranges from 0 to 7 % with breast
surgery plus sentinel lymph node (SLN) biopsy alone to 56 % two years after breast
surgery with both full axillary lymph node dissection (ALND) and axillary RT.
Patients who undergo axillary surgery and/or axillary RT for breast cancer are at
particular risk for the development of lymphedema as well as other arm morbidities.
Although a number of recommendations for prevention of lymphedema have been
published in review articles and in the nursing literature, there are no randomized
controlled trials that demonstrate the efficacy of one mode of prevention over another, or
even the efficacy of prophylactic measures over no such measures.
Prevention primarily focuses on restricting the use of axillary radiotherapy following
axillary dissection and specific surgical techniques to minimize damage to axillary
lymphatics (eg, limiting the extent of ALND) as the use of the sentinel lymph node biopsy
technique.
Common treatment interventions include: elevation, massage and exercise,
application of external pressure with compression garments or compression pumps and
complex physical therapy.Other modalities such as electrically stimulated lymphatic
drainage, may be used in combination as part of a multidisciplinary lymphedema program .