Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA.
Breast J. 2012 Jul-Aug;18(4):357-61. doi: 10.1111/j.1524-4741.2012.01252.x.
With improved outcomes following treatment of breast cancer, chronic toxicities including breast cancer related lymphedema (BCRL), gain increased significance with limited evidence-based guidelines present. This review attempts to summarize data addressing these concerns and provides recommendations based on currently published data. Substantial differences exist in rates of BCRL reported in the literature ranging from less than 5% to 65% based on locoregional therapy. Based on recent data, early diagnosis of BCRL appears critical and requires careful attention to patient risk factors and the use of newer diagnostic tools. Initial treatment with decongestive lymphatic therapy/compressive stockings can provide significant improvement in patient symptoms and volume reduction of edematous extremities. At this time, consensus recommendations for disease classification, diagnostic testing and treatment are still lacking. Awareness of the frequency of this toxicity is now important as more accurate clinical aids have become accessible to diagnose the condition at an earlier stage allowing timely intervention providing the opportunity for treatment strategies to be more effective.
随着乳腺癌治疗效果的改善，慢性毒性作用，包括乳腺癌相关淋巴水肿（BCRL），变得越来越重要，而目前仅有有限的基于证据的指南。本综述旨在总结针对这些问题的数据，并根据目前已发表的数据提出建议。根据局部区域治疗，文献中报告的 BCRL 发生率存在很大差异，从低于 5%到 65%不等。根据最近的数据，BCRL 的早期诊断至关重要，需要仔细注意患者的危险因素和使用新的诊断工具。早期采用消肿淋巴治疗/压缩袜可显著改善患者的症状和减轻水肿肢体的体积。目前，对于疾病分类、诊断测试和治疗的共识建议仍然缺乏。由于现在可以使用更准确的临床辅助工具来更早地诊断这种疾病，因此了解这种毒性的频率变得很重要，从而有机会进行及时干预，使治疗策略更有效。
