Roman Mirela Mariana, Barbieux Romain, Leduc Olivier, Bourgeois Pierre
1 Department of Mammo-Pelvic Surgery, Jules Bordet Institute , Brussels, Belgium .
2 Multi-disciplinary Clinic of Lymphology, Jules Bordet Institute , Brussels, Belgium .
Lymphat Res Biol. 2017 Mar;15(1):99-106. doi: 10.1089/lrb.2016.0037.
Aberrant, altered, or blocked lymphatic drainage may contribute to the high recurrence rate of breast cancer. Thus, an efficient evaluation of lymphatic drainage from the breasts and/or upper limbs is essential in the management of lymphedema and in ipsilateral primary or contralateral recurrent breast cancer patients. There are very few reports of lymphatic drainage to the paravertebral lymph nodes in patients with a lymphedema after breast cancer surgery with or without reconstruction.
We used lymphoscintigraphy to examine lymphatic drainage in a case series.
We observed five patients with upper limb and/or mammary lymphedema (after breast cancer surgery with or without reconstruction) who had lymphatic drainage from the upper limb or breast to the posterior intercostal and/or paravertebral lymph nodes. One patient also presented with nodal relapse at the time of our investigation.
The cases from this study demonstrate the unusual, and mostly unrecognized, lymphatic drainage pathways toward lymph nodes, which may be at risk for further evolution of breast cancer.
异常、改变或受阻的淋巴引流可能导致乳腺癌的高复发率。因此，有效评估乳房和/或上肢的淋巴引流对于淋巴水肿的管理以及同侧原发性或对侧复发性乳腺癌患者至关重要。关于乳腺癌手术伴或不伴重建后发生淋巴水肿的患者中，淋巴引流至椎旁淋巴结的报道极少。
我们使用淋巴闪烁造影术对一系列病例进行淋巴引流检查。
我们观察到5例上肢和/或乳腺淋巴水肿患者（乳腺癌手术伴或不伴重建后），其上肢或乳房的淋巴引流至后肋间和/或椎旁淋巴结。在我们进行调查时，1例患者还出现了淋巴结复发。
本研究中的病例显示了朝向淋巴结的异常且大多未被认识的淋巴引流途径，这些淋巴结可能存在乳腺癌进一步进展的风险。
