Sakorafas George H, Peros George, Cataliotti Luigi, Vlastos George
4th Department of Surgery, ATTIKON University Hospital, Athens University, Medical School, Arkadias 19 - 21, GR-115 26 Athens, Greece.
Surg Oncol. 2006 Nov;15(3):153-65. doi: 10.1016/j.suronc.2006.11.003. Epub 2006 Dec 21.
Lymphedema is a relatively common, potentially serious and unpleased complication after axillary lymph node dissection (ALND) for breast cancer. It may be associated with functional, esthetic, and psychological problems, thereby affecting the quality-of-life (QOL) of breast cancer survivors. Objective measurements (preferentially by measuring arm volumes or arm circumferences at predetermined sites) are required to identify lymphedema, but also subjective assessment can help to determine the clinical significance of any volume/circumference differences. Lymphedema per se predisposes to the development of other secondary complications, such as infections of the upper limb, psychological sequelae, development of malignant tumors, alterations of the QOL, etc. The risk of lymphedema is associated with the extent of ALND and the addition of axillary radiation therapy. Treatment involves the application of therapeutic measures of the so-called decongestive lymphatic therapy. Prevention is of key importance to avoid lymphedema formation. The application of the sentinel lymph node biopsy in the management of breast cancer has been associated with a reduced incidence of lymphedema formation.
淋巴水肿是乳腺癌腋窝淋巴结清扫术（ALND）后相对常见、潜在严重且令人不适的并发症。它可能与功能、美观和心理问题相关，从而影响乳腺癌幸存者的生活质量（QOL）。识别淋巴水肿需要客观测量（最好是在预定部位测量手臂体积或臂围），但主观评估也有助于确定任何体积/周长差异的临床意义。淋巴水肿本身易引发其他继发性并发症，如上肢感染、心理后遗症、恶性肿瘤的发生、生活质量的改变等。淋巴水肿的风险与腋窝淋巴结清扫术的范围以及腋窝放疗的附加使用有关。治疗包括应用所谓的消肿淋巴治疗措施。预防对于避免淋巴水肿的形成至关重要。前哨淋巴结活检在乳腺癌治疗中的应用与淋巴水肿形成的发生率降低有关。
