Simon M, Vignes S
Unité de Lymphologie, site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France.
Unité de Lymphologie, site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France.
J Med Vasc. 2019 Feb;44(1):3-8. doi: 10.1016/j.jdmv.2018.11.004. Epub 2018 Dec 20.
In France, breast cancer is the most frequent cancer in women. Lymphedema, the main complication, is poorly known. The objective of this study was to assess the state of knowledge of upper limb lymphedema (risk factors, complications, treatment) after treatment of breast cancer among general practitioners from the Haute-Normandie and Île-de-France regions.
A cross-sectional study with 23 closed questions was sent by email to 490 practicing doctors.
One hundred and sixty-two questionnaires (33%) could be analyzed. Among the participating physicians (men: 55%), 46% were aged over 50 and 75% were from the Haute-Normandie region; 86% of them followed at least 5 women who had breast cancer. Risk factors for lymphedema were: axillary dissection (89%), risk reduction with sentinel lymph node (82%), radiotherapy (81%), mastectomy (45%) and overweight/obesity (42%). For 54% of physicians, lymphedema appeared within 6 months after cancer treatment and was diagnosed upon examination (clinical signs, perimeter measurements) in 78%, without the need for radiological examinations (100%). Physicians with more than 10 years of experience searched for more lymphedema (86% vs. 62%, P<0.0001). Prescriptions included: elastic compression during the day (77%), manual lymphatic drainage (74%), overnight compression (36%) and consultation in a specialized lymphology department (8%). Six percent of physicians had never managed lymphedema and 22% sent patients to an oncologist. Advice given was: prevention of infectious risk (80%), weight loss (42%), avoidance of sports involving the affected limb (22%), and regular arm elevation (14%). Physicians recommended avoiding blood sampling (75%), measuring blood pressure (66%) on the limb ipsilateral to cancer, while 20% did not prohibit any action on the limb.
Lymphedema knowledge in general practitioners is generally adequate although the number of women followed by each of them was low. It seems necessary to optimize the training of generalists on lymphedema in order to improve patient management.
在法国，乳腺癌是女性中最常见的癌症。淋巴水肿作为主要并发症，却鲜为人知。本研究的目的是评估上诺曼底和法兰西岛地区全科医生对乳腺癌治疗后上肢淋巴水肿（危险因素、并发症、治疗）的了解状况。
通过电子邮件向490名执业医生发送了一项包含23个封闭式问题的横断面研究。
162份问卷（33%）可供分析。在参与调查的医生中（男性占55%），46%的年龄超过50岁，75%来自上诺曼底地区；其中86%的医生至少跟踪过5名患乳腺癌的女性。淋巴水肿的危险因素有：腋窝清扫术（89%）、前哨淋巴结活检降低风险（82%）、放疗（
