Hendrickx Ad A, Küthe Saskia W, van der Schans Cees P, Krijnen Wim P, Mouës-Vink Chantal M, Damstra Robert J
Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands.
Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands.
Cancers (Basel). 2022 Dec 6;14(23):6016. doi: 10.3390/cancers14236016.
The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change ≥5%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.
早期发现与乳腺癌相关的淋巴水肿并转诊接受治疗，有可能降低与淋巴水肿相关的发病率。尽管研究显示了其益处，但证据与日常实践之间仍存在差距。我们旨在确定按照当前指南，淋巴水肿的早期检测及转诊治疗是否充分。纳入接受保乳治疗或根治性治疗的原发性乳腺癌女性。记录人口统计学、一般健康状况、肿瘤及治疗相关数据。术前及术后3、6、12和24个月进行双侧手臂体积测量。相对体积变化5%或更大被视为淋巴水肿的临界点及治疗转诊指征。术后24个月，主要结果显示，在基于相对体积变化≥5%有淋巴水肿早期迹象的患者中，83%未转诊接受治疗。此外，我们观察到该组在24个月时平均相对体积变化有显著改善，这可能意味着不转诊是一个合适的选择，并且在术后第一年内检测到淋巴水肿时，密切观察等待是合适的。
