Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil.
Departamento de Ciências das Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de são Paulo, Ribeirão Preto, São Paulo, Brasil.
PLoS One. 2022 Apr 20;17(4):e0264160. doi: 10.1371/journal.pone.0264160. eCollection 2022.
The treatment of breast cancer is often complicated by lymphedema of the upper limbs. Standard lymphedema evaluation methodologies are not able to measure tissue fibrosis. The ultrasound aspects related to tissue microstructures of lymphedema are neglected in clinical evaluations. The objective of this study was to identify and measure the degree of impairment, topography, and biophysical alterations of subcutaneous lymphedema tissue secondary to the treatment of breast cancer by ultrasonography. Forty-two women at a mean age of 58 (±9.7) years, with unilateral lymphedema due to breast cancer treatment, were evaluated. The upper limbs were divided into affected (affected by lymphedema) and control (contralateral limb). Each limb was subdivided into seven areas, defined by perimetry, evaluated in pairs. The biophysical characteristics thickness, entropy, and echogenicity were evaluated by ultrasonography. The results showed a significant difference in the echogenicity and thickness variables between the affected and unaffected upper limb, in all the extent of the upper limb, while entropy showed no significant difference. The findings indicate that the data presented were consistent both in identifying and measuring the degree of impairment and biophysical changes in the subcutaneous tissue of lymphedema secondary to the treatment of breast cancer.
乳腺癌的治疗常因上肢淋巴水肿而变得复杂。标准的淋巴水肿评估方法无法测量组织纤维化。临床评估中忽略了与淋巴水肿组织微观结构相关的超声表现。本研究旨在通过超声检查识别和测量乳腺癌治疗后继发的皮下淋巴水肿组织的损伤程度、分布和生物物理改变。42 名年龄 58 岁（±9.7）岁的女性，因单侧乳腺癌治疗后发生淋巴水肿，纳入研究。上肢分为患病侧（淋巴水肿侧）和对照侧（对侧）。每条肢体通过周边测量法被分为七个区域，通过超声检查对其进行配对评估。生物物理特征厚度、熵和回声性进行评估。结果显示，在整个上肢范围内，患病侧和未患病侧上肢的回声性和厚度变量均有显著差异，而熵变量无显著差异。研究结果表明，本研究提供的数据在识别和测量乳腺癌治疗后继发的皮下淋巴水肿组织的损伤程度和生物物理变化方面是一致的。
