AdventHealth Cancer Institute, Gynecologic Oncology Program, Orlando, FL, 32804, USA; Valencia College, Department of Health Sciences, Section of Human Anatomy & Physiology, Orlando, FL, 32802, USA.
AdventHealth Cancer Institute, Gynecologic Oncology Program, Orlando, FL, 32804, USA.
Surg Oncol. 2024 Oct;56:102124. doi: 10.1016/j.suronc.2024.102124. Epub 2024 Aug 23.
Lymphedema is a chronic and debilitating condition characterized by an abnormal buildup of protein-rich fluid in the interstitial tissue, leading to the development of edema and tissue structural alterations. Breast cancer-related lymphedema (BCRL) remains a significant healthcare burden because it can develop within days and up to 11-years after the surgery. Specifically, axillary lymph node dissection leads to 30-50 % upper limb lymphedema, which involves the accumulation of protein-rich fluid. In this article, we provide a comprehensive/critical overview of post-mastectomy lymphedema, focusing on key aspects as diagnosis, prevention, and treatment methods. Beginning with clinical condition, the article explores the pathophysiology and risk factors associated with post-mastectomy lymphedema. It further delves into various diagnostic modalities available, highlighting the importance of early detection for optimal management of BCRL. We also examine preventive strategies, emphasizing the role of patient education, lifestyle modifications, and proactive measures in reducing the risk of lymphedema development. In terms of treatment, the article covers a wide array of interventions ranging from conservative approaches like manual lymphatic drainage and compression therapy to surgical techniques such as lymph node transfer and lymphaticovenular anastomosis. Thus, through a comprehensive synthesis of current evidence and clinical practices updates, the review aims to guide healthcare professionals in delivering preventive and effective care while improving outcomes for individuals affected by post-mastectomy lymphedema.
淋巴水肿是一种慢性且使人虚弱的疾病，其特征是间质组织中异常积聚富含蛋白质的液体，导致水肿和组织结构改变。乳腺癌相关淋巴水肿（BCRL）仍然是一个重大的医疗保健负担，因为它可以在手术后几天至 11 年内发展。具体来说，腋窝淋巴结清扫术导致 30-50%的上肢淋巴水肿，涉及富含蛋白质的液体积聚。在本文中，我们提供了乳腺癌根治术后淋巴水肿的全面/批判性概述，重点关注诊断、预防和治疗方法的关键方面。文章从临床情况开始，探讨了与乳腺癌根治术后淋巴水肿相关的病理生理学和风险因素。它进一步深入探讨了各种可用的诊断方式，强调了早期检测对于 BCRL 最佳管理的重要性。我们还研究了预防策略，强调了患者教育、生活方式改变和主动措施在降低淋巴水肿发展风险方面的作用。在治疗方面，本文涵盖了广泛的干预措施，包括从保守方法如手动淋巴引流和压缩治疗到手术技术如淋巴结转移和淋巴管静脉吻合术。因此，通过对当前证据和临床实践更新的综合综合，该综述旨在指导医疗保健专业人员提供预防和有效的护理，同时改善受乳腺癌根治术后淋巴水肿影响的个体的结局。
