Valinote Sarah Patrizia Araújo, de Freitas-Junior Ruffo, Martins Karine Anusca, Pereira Antônio César, Pereira Charles Esteves, Martins Edésio
Pós-Graduação em Ciências da Saúde, Universidade Federal de Goiás, UFG, Goiânia (GO), Brasil.
Rev Bras Ginecol Obstet. 2013 Apr;35(4):171-7. doi: 10.1590/s0100-72032013000400007.
To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment.
This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs.
Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered.
The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.
评估因乳腺癌治疗而行腋窝淋巴结清扫术后发生淋巴水肿的女性患者腋窝-锁骨下静脉及淋巴系统的变化。
这是一个病例系列研究,涉及11例因乳腺癌治疗而行腋窝淋巴结清扫术后出现单侧上肢淋巴水肿的女性患者。该研究于2010年3月至2011年3月期间在戈亚斯联邦大学戈亚尼亚临床医院乳腺科项目中进行。采用多普勒测速超声检测锁骨下静脉和腋窝静脉的静脉变化情况。通过淋巴闪烁显像评估双上肢的淋巴变化。采用Fisher精确检验对双侧上肢进行比较。
发生淋巴水肿的上肢锁骨下静脉血流量与对侧上肢有显著差异(p<0.001),54.6%的女性血流量增加。在腋窝静脉中,45.4%血流量增加,45.4%血流量减少,双侧之间存在统计学显著差异(p<0.01)。与对侧上肢相比,在淋巴管走行(未显影)、淋巴管数量(无)、腋窝淋巴结(无)和皮肤反流(存在)方面也发现了显著的淋巴变化(p<0.05)。在未发生淋巴水肿的对侧上肢,未发现静脉或淋巴改变。
因乳腺癌治疗而行腋窝淋巴结清扫术的女性患者,发生淋巴水肿的上肢出现了静脉和淋巴变化。