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乳腺癌相关淋巴水肿

Breast cancer-related lymphedema.

作者信息

Morrell Rosalyn M, Halyard Michele Y, Schild Steven E, Ali Muna S, Gunderson Leonard L, Pockaj Barbara A

机构信息

Department of Radiation Oncology, Mayo Clinic College of Medicine, Scottsdale, Arizona 85259, USA.

出版信息

Mayo Clin Proc. 2005 Nov;80(11):1480-4. doi: 10.4065/80.11.1480.

Abstract

Every year in the United States, breast cancer is diagnosed in more than 200,000 women. Because of the prevalence of breast cancer, treatment-related sequelae are of Importance to many survivors of the disease. One such sequela is upper extremity lymphedema, which occurs when fluid accumulates in the Interstitial space and causes enlargement and usually a feeling of heaviness in the limb. Axillary surgery contributes considerably to the incidence of lymphedema, with the incidence and severity of swelling related to the number of lymph nodes removed. Lymphedema after standard axillary lymph node dissection can occur in up to approximately 50% of patients. However, the risk of lymphedema is decreased substantially with newer sentinel lymph node sampling procedures. Adjuvant radiotherapy to the breast or lymph nodes increases the risk of lymphedema, which has been reported in 9% to 40% of these patients. Management of lymphedema requires a multidisciplinary approach to minimize the effect on the patient's quality of life. This review presents an overview of the pathophysiology, diagnosis, prevention, and treatment of breast cancer-related lymphedema.

摘要

在美国,每年有超过20万名女性被诊断出患有乳腺癌。由于乳腺癌的普遍性,与治疗相关的后遗症对许多该疾病的幸存者来说至关重要。其中一种后遗症是上肢淋巴水肿,当液体在间质间隙积聚并导致肢体肿大且通常伴有沉重感时就会发生。腋窝手术在很大程度上导致了淋巴水肿的发生率,肿胀的发生率和严重程度与切除的淋巴结数量有关。标准腋窝淋巴结清扫术后,高达约50%的患者可能会出现淋巴水肿。然而,采用更新的前哨淋巴结取样程序可大幅降低淋巴水肿的风险。对乳房或淋巴结进行辅助放疗会增加淋巴水肿的风险,据报道,这些患者中有9%至40%会出现这种情况。淋巴水肿的管理需要多学科方法,以尽量减少对患者生活质量的影响。本综述概述了乳腺癌相关淋巴水肿的病理生理学、诊断、预防和治疗。

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