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Lymphedema breast cancer

Hoda S Hashemi, Stefanie Fallone, Mathieu Boily, Anna Towers, Robert D Kilgour, Hassan Rivaz
Breast cancer-related lymphedema (BCRL) is a consequence of a malfunctioning lymphatic drainage system resulting from surgery or some other form of treatment. In the initial stages, minor and reversible increases in fluid volume of the arm are evident. As the stages progress over time, the underlying pathophysiology dramatically changes with an irreversible increase in arm volume most likely due to a chronic local inflammation leading to adipose tissue hypertrophy and fibrosis. Clinicians have subjective ways to stage the degree and severity such as the pitting test which entails manually comparing the elasticity of the affected and unaffected arms...
October 15, 2018: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Stanley G Rockson
No abstract text is available yet for this article.
October 2018: Lymphatic Research and Biology
Mattias Hoffner, Karin Ohlin, Barbro Svensson, Jonas Manjer, Emma Hansson, Thomas Troëng, Håkan Brorson
Background: Arm lymphedema is a well-recognized complication after breast cancer surgery that negatively impacts patients' quality of life, both physiologically and psychologically. Lymph stasis and inflammation result in excess formation of adipose tissue, which makes removal of the deposited subcutaneous fat necessary to eliminate the excess volume. Liposuction, combined with postoperative controlled compression therapy (CCT), is the only treatment that gives complete reduction of the excess volume...
August 2018: Plastic and Reconstructive Surgery. Global Open
Rachelle Crescenzi, Paula M Donahue, Vaughn G Braxton, Allison O Scott, Helen B Mahany, Sarah K Lants, Manus J Donahue
The purpose of this work was to quantify 3.0 T (i) T1 and T2 relaxation times of in vivo human lymph nodes (LNs) and (ii) LN relaxometry differences between healthy LNs and LNs from patients with lymphatic insufficiency secondary to breast cancer treatment-related lymphedema (BCRL). MR relaxometry was performed over bilateral axillary regions at 3.0 T in healthy female controls (105 LNs from 20 participants) and patients with BCRL (108 LNs from 20 participants). Quantitative T1 maps were calculated using a multi-flip-angle (20, 40, 60°) method with B1 correction (dual-TR method, TR1 /TR2  = 30/130 ms), and T2 maps using a multi-echo (TE  = 9-189 ms; 12 ms intervals) method...
October 12, 2018: NMR in Biomedicine
Seung Yeon Rhee, Sang Yoon Lee, Ha Ra Jeon
Lymphedema is a condition characterized by localized fluid retention and tissue swelling caused by a compromised lymphatic system. To minimize fluid build-up and stimulate the flow of fluid through the lymphatic system, compression garments are usually applied to patients with lymphedema. There are few studies to report complications of compression garments to treat breast cancer-related lymphedema. To our knowledge, this is the first report of radial nerve compression neuropathy associated with wearing a compression garment to treat lymphedema...
October 6, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
N M Toyserkani, C H Jensen, S Tabatabaeifar, M G Jørgensen, S Hvidsten, J A Simonsen, D C Andersen, S P Sheikh, J A Sørensen
BACKGROUND: Breast cancer-related lymphedema (BCRL) is a feared late complication. Treatment options are lacking at present. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with adipose-derived regenerative cells (ADRCs) for treating BCRL with 1 year of follow-up. MATERIAL AND METHODS: We included 10 patients with BCRL. ADRCs were injected directly into the axillary region together with a scar-releasing fat grafting procedure...
September 20, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Yukio Seki, Akiyoshi Kajikawa, Takumi Yamamoto, Takayuki Takeuchi, Takahiro Terashima, Norimitsu Kurogi
BACKGROUND: Lymphaticovenular anastomosis (LVA) is generally an effective procedure for breast cancer treatment-related upper extremity lymphedema (UEL). Clinical improvement is, however, limited by the degree of sclerosis of the lymphatic vessels. We have developed a method by which we use dynamic ultrasonography to depict vessels through which lymph can be propelled into the LVA under the power of the patient's natural hand movements. METHODS: We assessed the dynamic-LVA method by comparing clinical details of 15 cases of breast cancer treatment-related lymphedema treated by dynamic LVA and 15 corresponding cases treated by conventional LVA...
September 20, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Bryan Spinelli, Michael J Kallan, Xiaochen Zhang, Andrea Cheville, Andrea Troxel, Joy Cohn, Lorraine Dean, Kathleen Sturgeon, Margaret Evangelista, Zi Zhang, David Ebaugh, Kathryn H Schmitz
OBJECTIVE: The goal of this study was to develop and assess intra and inter-rater reliability and validity of a clinical evaluation tool for breast cancer related lymphedema, for use in the context of outcome evaluation in clinical trials DESIGN: Blinded repeated measures observational study. SETTING: Outpatient research laboratory. PARTICIPANTS: Breast cancer survivors with and without lymphedema (N=71). INTERVENTIONS: Not applicable...
October 3, 2018: Archives of Physical Medicine and Rehabilitation
Bolette S Rafn, Margaret L McNeely, Pat G Camp, Julie Midtgaard, Kristin L Campbell
Background: Prospective surveillance by physical therapists enables early detection and treatment of breast cancer-related lymphedema (BCRL). Strategies to increase access to prospective surveillance could reduce the burden of BCRL on patients and the health system. One potential solution is self-managed surveillance that does not require in-person assessment by a specialized physical therapist. Objective: The objective was to develop and test the reliability and validity of a written and video-supported protocol for women with breast cancer to self-measure arm circumference...
October 4, 2018: Physical Therapy
Juhi Agrawal, Sandeep Mehta, Ashish Goel, Pankaj Kumar Pande, Kapil Kumar
Lymphatic microsurgical preventing healing approach (LYMPHA) for prevention of breast cancer-related lymphedema (BCRL)-a preliminary report BCRL-is a chronic debilitating condition which impairs quality of life of breast cancer survivors. The aim is to study the feasibility of preventing lymphedema by performing "Lymphatic Microsurgical Preventive Healing Approach (LYMPHA)." Patients undergoing breast cancer surgery with complete nodal dissection were taken up for the study. After the standard axillary nodal dissection, lymphatics were identified by the help of blue dye and were anastomosed with a tributary to the axillary vein...
September 2018: Indian Journal of Surgical Oncology
Burcu Duyur Cakıt, Secil Pervane Vural, F Figen Ayhan
BACKGROUND: The aim of this prospective clinical study was to compare the long-term efficacy of complex decongestive therapy (CDT) in obese and nonobese patients with breast cancer-related lymphedema (BCRL). MATERIALS AND METHODS: A total of 59 patients (29 obese patients group 1, 30 normoweight overweight patients group 2) with unilateral BCRL were enrolled. All patients underwent CDT that included manual lymphatic drainage, intermittent pneumatic compression pump, multilayer compression bandaging, lymphedema exercises, and skin care...
October 3, 2018: Lymphatic Research and Biology
Myriam Preuß, Renee Killaars, Andrzej Piatkowski de Grzymala, Marcel Binnebösel, Ulf Neumann
BACKGROUND: In the past, measurement of upper limb lymphedema was done by water displacement (WD), which is frequently cited as the gold standard. For various reasons, however, the use of WD is restricted in clinical settings. A more precise and easy-to-use method would be favorable. The high precision of three-dimensional (3D) imaging in comparison to WD has already been reported for healthy subjects. The aim of this study is to determine the validity and reliability of 3D imaging by comparing it to the WD method in women with unilateral upper limb lymphedema...
October 3, 2018: Lymphatic Research and Biology
Mohaned O Abass, Mohamed D A Gismalla, Ahmed A Alsheikh, Moawia M A Elhassan
PURPOSE: Axillary lymph node dissection (ALND) frequently is performed as part of the surgical management of breast cancer as a therapeutic and prognostic index, but increasingly has been perceived as associated with significant complications. Data on efficacy and complications of ALND in Sudan are lacking. The aim of this study was to assess the efficacy and complications of ALND in patients with breast cancer treated with mastectomy and breast-conserving surgery. METHODS: We performed a prospective, hospital-based study in women with invasive breast cancer who underwent modified radical mastectomy or breast-conserving surgery with ALND between September 2014 and August 2015...
October 2018: Journal of Global Oncology
Megan L Steele, Monika Janda, Dimitrios Vagenas, Leigh C Ward, Bruce H Cornish, Robyn Box, Susan Gordon, Melanie Matthews, Sally D Poppitt, Lindsay D Plank, Wilson Yip, Angela Rowan, Hildegard Reul-Hirche, Andreas Obermair, Sandra C Hayes
BACKGROUND: Bioimpedance spectroscopy detects unilateral lymphedema if the ratio of extracellular fluid (ECF) between arms or between legs is outside three standard deviations (SDs) of the normative mean. Detection of bilateral lymphedema, common after bilateral breast or gynecological cancer, is complicated by the unavailability of an unaffected contralateral limb. The objectives of this work were to (1) present normative values for interarm, interleg, and arm-to-leg impedance ratios of ECF and ECF normalized to intracellular fluid (ECF/ICF); (2) evaluate the influence of sex, age, and body mass index on ratios; and (3) describe the normal change in ratios within healthy individuals over time...
October 2, 2018: Lymphatic Research and Biology
Shirin M Shallwani, Anna Towers
Purpose: Malignant lymphedema is an accumulation of interstitial fluid caused by tumour infiltration or compression of lymphatic vessels. Our objective is to describe self-management strategies for malignant lymphedema using a case report. Client Description: A 50-year-old woman with advanced breast cancer was referred to our centre with a 3-month history of unexplained left-arm edema, subsequently diagnosed as malignant lymphedema caused by tumour compression of the axillary lymph nodes. Intervention: She undertook a physiotherapist-guided, modified lymphedema treatment programme, with self-management interventions including self-bandaging and exercise...
2018: Physiotherapy Canada. Physiothérapie Canada
M Karafa, A Karafova, A Szuba
This study evaluated how different levels of pressure under inelastic multi-layer bandages affect the reduction of secondary arm lymphedema and patient comfort throughout therapy. Ninety-six women with lymphedema after breast cancer treatment were randomized into three groups of 32 patients depending on level of applied pressure in compression therapy: group I (control) at 21-30 mmHg; study groups II A at 31-40 mmHg and group II B at 41-60 mmHg. All patients were treated with complex decongestive therapy (CDT) and intermittent pneumatic compression (IPC) before compression...
2018: Lymphology
Dawn Lemanne, Victoria Maizes
A majority of women undergoing conventional treatment for breast cancer also undertake complementary and integrative approaches. Practitioners knowledgeable about the evidence base behind common integrative approaches can help patients attain improved quality of life, and at times, improved survival. Evidence-based recommendations include the following: a plant-based diet for general health after diagnosis, and carbohydrate restriction for patients with estrogen receptor-positive postmenopausal breast cancer may be prudent...
September 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Awatef Kelati, Salim Gallouj
BACKGROUND: Cutaneous metastatic breast cancer is the most common cutaneous metastatic malignancy in women. The assessment of cutaneous metastatic disease can be perplexing because the clinical presentation appears similar to other skin malignancies like angiosarcoma or melanoma, or benign diseases like cellulitis and lymphedema. To date, only a limited number of dermoscopic images of cutaneous metastatic solid tumors, especially breast cancer, have been published. CASE PRESENTATION: The authors report two Moroccan cases highlighting dermoscopy as a quick tool to recognize skin metastasis of breast cancer in two different clinical presentations...
September 22, 2018: Journal of Medical Case Reports
Zeynep Erdogan Iyigun, Filiz Agacayak, Ahmet Serkan Ilgun, Filiz Elbuken Celebi, Cetin Ordu, Gul Alco, Alper Ozturk, Tomris Duymaz, Fatma Aktepe, Vahit Ozmen
BACKGROUND: Early detection of lymphedema gives an opportunity for effective and successful treatment of lymphedema. However, the current diagnosis methods, except the bioimpedance analysis, perometry, and indocyanine green lymphography, have limitations in detecting early stage lymphedema. Sonoelastography is a diagnostic ultrasound technique that provides an opportunity to estimate soft tissue stiffness. Shear wave elastography (SWE) is a brand new elastography technique. Unlike strain elastography, this method is conducted automatically, that is, independently of user's manual tissue compression...
September 13, 2018: Lymphatic Research and Biology
Oscar Ochoa, Michael Metzner, Constantine Theoharis, Minas Chrysopoulo, Steven Pisano, Chet Nastala, Peter Ledoux, Gary Arishita, Ramon Garza, Ted Snider
INTRODUCTION: Breast cancer-related extremity lymphedema is a potentially devastating condition. Vascularized lymph node transfer (VLNT) has shown benefit in lymphedema treatment. Due to concerns over potential iatrogenic complications, various donor sites have been described. The current study aims at defining the deep inferior epigastric lymph node basin as a novel donor site for VLNT. METHODS: A retrospective study was performed on patients undergoing routine abdominal-based breast reconstruction...
September 5, 2018: Microsurgery
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