Faculty of Medicine of University of Novi Sad, Novi Sad, Serbia.
Department of Nursing, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
BMC Womens Health. 2024 Apr 6;24(1):226. doi: 10.1186/s12905-024-03062-7.
Breast cancer-related lymphedema (BCRL) is a potentially disabling and often irreversible consequence of breast cancer treatment, caused by the mechanical incompetence of the lymphatic system, resulting in reduced drainage capacity and functional overload due to an excessive volume of interstitial fluid surpassing the system's transport capacity in the arm. We wanted to determine the impact and explore the differences in independent risk factors for the occurrence of BCRL; incidence of BCRL over a five-year period at the Institute of Oncology Vojvodina in Sremska Kamenica and to answer the research question regarding the influence of the prehabilitation program on the overall incidence of BCRL during the observed five-year period.
From 2014 to 2018, a retrospective study was conducted at the Institute of Oncology of Vojvodina in Sremska Kamenica, analyzing female patients who had undergone breast cancer surgery.
The study included 150 breast cancer patients who developed secondary lymphedema following surgery with the mean age of 59.2 ± 11.3 years. Fluctuations in hospitalization rates were observed over the five-year period, with the highest number of admissions in 2014 (24.0%) and a decline in 2018 (14.0%). The most common surgical procedure performed was left quadrantectomy (24.0%), followed by right quadrantectomy (20.0%) and left amputation (15.3%). The mean number of removed lymph nodes was 15.2 ± 6.1, with no statistically significant association between the number of removed lymph nodes and the manifestation of secondary lymphedema. The severity of secondary lymphedema varied based on patient age, with a higher incidence of moderate and severe lymphedema observed in patients aged 61 years and older. Patients who underwent radical surgery were more likely to experience severe lymphedema compared to those who had conservative surgery, although this difference was not statistically significant.
In our study, the type of surgery, elapsed time since surgery, and the number of removed lymph nodes were not influencing factors for the occurrence of BCRL. However, concerning its severity, a greater number of systemic therapy modalities combined with radiotherapy were associated with a more frequent occurrence of mild and moderate BCRL. Also, the severity of BCRL varied among different age groups, with a higher incidence of moderate and severe lymphedema observed in patients aged 61 years and older. Ultimately, improving the quality of life for individuals affected by secondary lymphedema remains a crucial goal in the field of oncology.
乳腺癌相关淋巴水肿（BCRL）是乳腺癌治疗后一种潜在的致残且常不可逆的后果，由淋巴系统的机械功能不全引起，导致引流能力下降和功能超负荷，因为间质液的体积过大，超过了手臂中系统的运输能力。我们想确定发生 BCRL 的独立风险因素的影响并探索其差异；在 Sremska Kamenica 的伏伊伏丁那肿瘤研究所五年期间 BCRL 的发生率，并回答关于观察期五年期间康复前计划对整体 BCRL 发生率影响的研究问题。
2014 年至 2018 年，在 Sremska Kamenica 的伏伊伏丁那肿瘤研究所进行了一项回顾性研究，分析了接受过乳腺癌手术的女性患者。
该研究纳入了 150 名手术后发生继发性淋巴水肿的乳腺癌患者，平均年龄为 59.2±11.3 岁。五年期间住院率波动，2014 年入院人数最多（24.0%），2018 年下降（14.0%）。最常见的手术是左象限切除术（24.0%），其次是右象限切除术（20.0%）和左截肢术（15.3%）。平均切除的淋巴结数为 15.2±6.1，切除的淋巴结数与继发性淋巴水肿的表现之间无统计学显著关联。继发性淋巴水肿的严重程度取决于患者年龄，61 岁及以上患者中中度和重度淋巴水肿的发生率更高。与接受保守手术的患者相比，接受根治性手术的患者更有可能发生重度淋巴水肿，尽管这种差异无统计学意义。
在我们的研究中，手术类型、手术时间和切除的淋巴结数量不是 BCRL 发生的影响因素。然而，就其严重程度而言，更多的全身性治疗方式联合放疗与轻度和中度 BCRL 的更频繁发生相关。此外，BCRL 的严重程度在不同年龄组之间有所不同，61 岁及以上患者中中度和重度淋巴水肿的发生率更高。最终，提高继发性淋巴水肿患者的生活质量仍然是肿瘤学领域的一个关键目标。
