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乳腺癌相关淋巴水肿的特征、预测因素及治疗

Features, Predictors, and Treatment of Breast Cancer-related Lymphedema.

作者信息

Zhang Xiaochen, Oliveri Jill M, Paskett Electra D

机构信息

Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH.

出版信息

Curr Breast Cancer Rep. 2020 Dec;12(4):244-254. doi: 10.1007/s12609-020-00381-0. Epub 2020 Sep 9.

Abstract

PURPOSE OF REVIEW

Breast cancer-related lymphedema (BCRL) is a common sequelae among breast cancer survivors. This review provides updated information on recent studies to prevent, diagnose, and actively treat women with BCRL.

RECENT FINDINGS

In total, 63 articles were identified from 2015 and 2020 that assessed incidence, risk factors, surveillance, measurement and definition, treatment, and awareness of BCRL. Depending on the approach and timing of assessment, BCRL incidence rates ranged from 9.1% to 39%. Modified radical mastectomy, number of positive lymph nodes, and postoperative complications were linked to BCRL risk, in addition to chemotherapy, radiation, axillary lymph node dissection, advanced cancer stage, and higher body mass index. Early detection showed favorable BCRL outcomes (e.g., severity, symptoms). Exercise, self-management, complete decongestive therapy, bandaging, and surgery had positive effects on BCRL outcomes.

SUMMARY

Numerous gaps exist within BCRL literature, such as the value of self-reported surveillance options to identify BCRL early, measurement strategies, and definitions of BCRL. In terms of policies, efforts are needed to educate providers, patients, payers, and legislators about the need for consensus to reduce the burden of BCRL in women being treated for breast cancer.

摘要

综述目的

乳腺癌相关淋巴水肿(BCRL)是乳腺癌幸存者中常见的后遗症。本综述提供了关于近期预防、诊断和积极治疗BCRL女性患者的研究的最新信息。

最新发现

从2015年至2020年共检索到63篇评估BCRL发病率、危险因素、监测、测量与定义、治疗以及认知情况的文章。根据评估方法和时间的不同,BCRL发病率在9.1%至39%之间。除化疗、放疗、腋窝淋巴结清扫、癌症晚期以及较高的体重指数外,改良根治性乳房切除术、阳性淋巴结数量和术后并发症与BCRL风险相关。早期检测显示出较好的BCRL治疗效果(如严重程度、症状)。运动、自我管理、完全减压疗法、包扎和手术对BCRL治疗效果有积极影响。

总结

BCRL文献中存在许多空白,如自我报告监测选项在早期识别BCRL中的价值、测量策略以及BCRL的定义。在政策方面,需要努力教育医疗服务提供者、患者、支付方和立法者,使其认识到达成共识以减轻乳腺癌治疗女性BCRL负担的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/708d/8130904/473322423440/nihms-1700356-f0001.jpg

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Features, Predictors, and Treatment of Breast Cancer-related Lymphedema.乳腺癌相关淋巴水肿的特征、预测因素及治疗
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