Thiadens S R
National Lymphedema Network, Inc., San Francisco, CA 94115-3417, USA.
Cancer. 1998 Dec 15;83(12 Suppl American):2864-8. doi: 10.1002/(sici)1097-0142(19981215)83:12b+<2864::aid-cncr40>3.0.co;2-b.
Secondary lymphedema (LE) resulting from breast cancer surgery has continued to be an ignored medical diagnosis in U.S. medicine. Subsequently, the majority of women/men undergoing axillary lymph node dissection have not received education in pre- or postoperative LE prevention, causing hundreds of thousands of patients to develop LE. As a result of this ignorance, once the LE develops, these patients receive no or harmful treatment.
Over the last decade, the National Lymphedema Network (NLN) has created awareness in the medical community, among patients, and in the general public through information dissemination, educational materials, a national conference, and the activism of patients and a small group of concerned professionals. Complete decongestive physiotherapy (CDP), which includes manual lymph drainage, is a successful treatment for LE that has now been introduced.
Slowly, the U.S. medical community is beginning to recognize and support this condition and its treatment, and secondary LE has now become an acceptable diagnosis (ICD9-457.0). Subsequently, due to patient and medical activism and the work of the NLN, Medicare now covers 2 weeks of CDP treatment (in Florida), and two landmark bills (AB-12 and S-609) that will cover LE treatment for postbreast carcinoma patients are currently pending (as of February 22, 1998).
In the last decade, the NLN has developed a strong foundation of knowledge and has planted LE on the medical map in the United States. With collaboration between the NLN and all breast carcinoma groups and LE specialists, it is hoped that lymphology will become a standard course of study in medical schools across the country and that LE will become a household word, with proper treatment available for postbreast carcinoma LE patients in the United States.
在美国医学中，乳腺癌手术导致的继发性淋巴水肿（LE）一直是一个被忽视的医学诊断。随后，大多数接受腋窝淋巴结清扫术的女性/男性在术前或术后未接受过LE预防教育，导致数十万患者患上LE。由于这种忽视，一旦LE发展起来，这些患者得不到治疗或接受有害治疗。
在过去十年中，国家淋巴水肿网络（NLN）通过信息传播、教育材料、全国会议以及患者和一小群相关专业人员的积极行动，提高了医学界、患者和公众的认识。包括手法淋巴引流在内的完全减压物理治疗（CDP）是一种治疗LE的成功方法，现已被引入。
美国医学界开始慢慢认识并支持这种疾病及其治疗方法，继发性LE现已成为一个可接受的诊断（国际疾病分类第九版-457.0）。随后，由于患者和医疗界的积极行动以及NLN的工作，医疗保险现在覆盖2周的CDP治疗（在佛罗里达州），两项具有里程碑意义的法案（AB-12和S-609）将覆盖乳腺癌术后患者的LE治疗，目前正在等待审批（截至1998年2月22日）。
在过去十年中，NLN奠定了坚实的知识基础，并将LE在美国医学地图上确立了下来。希望通过NLN与所有乳腺癌团体和LE专家的合作，淋巴学将成为美国各地医学院校的标准课程，LE将成为一个家喻户晓的词汇，美国乳腺癌术后LE患者能够得到适当的治疗。
