Five-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1-4N1-3M0 Breast Cancer.
Five-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1-4N1-3M0 Breast Cancer.
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ALND时LYMPHA治疗临床T1-4N1-3M0乳腺癌的五年乳腺外科医生经验。
DOI：
10.1245/s10434-021-10551-8
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发表时间：
2021-10
影响因子：
3.7
通讯作者：
Spiguel LR
中科院分区：
文献类型：
--
作者：
Herremans KM;Cribbin MP;Riner AN;Neal DW;Hollen TL;Clevenger P;Munoz D;Blewett S;Giap F;Okunieff PG;Mendenhall NP;Bradley JA;Mendenhall WM;Mailhot-Vega RB;Brooks E;Daily KC;Heldermon CD;Marshall JK;Hanna MW;Leyngold MM;Virk SS;Shaw CM;Spiguel LR
乳腺癌相关性水肿（BCRL）是乳腺癌幸存者术后发病率的来源。淋巴显微外科预防性愈合方法（LYMPHA）是一种在腋窝淋巴结清扫术（ALND）时用于预防BCRL的技术。我们报告了一名接受过LYMPHA培训的乳腺外科医生的5年经验，并调查了在ALND治疗cT 1 - 4 N1 - 3 M0乳腺癌后接受LYMPHA的患者的结局。对接受ALND联合和不联合LYMPHA的T1- 4 N1 - 3 M0乳腺癌患者进行了回顾性分析。BCRL的诊断由经认证的水肿治疗师进行。使用Fisher精确或Wilcoxon秩和检验的结果分析描述性统计量和水肿监测数据。进行逻辑回归和倾向匹配以评估LYMPHA后BCRL发生率的降低。在5年期间，132例患者符合入选标准，其中76例患者在ALND时接受了LYMPHA，56例患者仅接受了ALND。在ALND时接受LYMPHA的患者发生BCRL的可能性显著低于仅接受ALND的患者（p=0.045）。与BCRL发生相关的风险因素为患者年龄增加（p=0.007）、BMI（p=0.003）以及接受LYMPHA的患者中阳性淋巴结数量增加（p=0.026）。在ALND时，接受过血管-静脉吻合术培训的乳腺外科医生可成功使用LYMPHA。虽然研究工作应继续关注BCRL的预防和监测，但LYMPHA仍然是减少BCRL和改善患者生活质量的一种选择。
Breast cancer-related lymphedema (BCRL) is a source of postoperative morbidity for breast cancer survivors. Lymphatic microsurgical preventive healing approach (LYMPHA) is a technique used to prevent BCRL at the time of axillary lymph node dissection (ALND). We report the 5-year experience of a breast surgeon trained in LYMPHA and investigate the outcomes of patients who underwent LYMPHA following ALND for the treatment of cT1-4N1-3M0 breast cancer. A retrospective review of patients with T1-4N1-3M0 breast cancer was performed in patients who underwent ALND with and without LYMPHA. Diagnosis of BCRL was made by certified lymphedema therapists. Descriptive statistics and lymphedema surveillance data were analyzed using results of Fisher’s exact or Wilcoxon rank sum tests. Logistic regression and propensity matching were performed to assess the reduction of BCRL occurrence following LYMPHA. In a 5-year period, 132 patients met inclusion criteria with 76 patients undergoing LYMPHA at the time of ALND and 56 patients undergoing ALND alone. Patients who underwent LYMPHA at the time of ALND were significantly less likely to develop BCRL than those who underwent ALND alone (p=0.045). Risk factors associated with BCRL development were increased patient age (p=0.007), BMI (p=0.003), and, in patients undergoing LYMPHA, the number of positive nodes (p=0.026). LYMPHA may be successfully employed by breast surgeons trained in lymphatic-venous anastomosis at the time of ALND. While research efforts should continue to focus on the prevention and surveillance of BCRL, LYMPHA remains an option to reduce BCRL and improve patient quality of life.
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DOI：
10.1016/s1470-2045(14)70460-7
发表时间：
2014-11
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Donker M;van Tienhoven G;Straver ME;Meijnen P;van de Velde CJ;Mansel RE;Cataliotti L;Westenberg AH;Klinkenbijl JH;Orzalesi L;Bouma WH;van der Mijle HC;Nieuwenhuijzen GA;Veltkamp SC;Slaets L;Duez NJ;de Graaf PW;van Dalen T;Marinelli A;Rijna H;Snoj M;Bundred NJ;Merkus JW;Belkacemi Y;Petignat P;Schinagl DA;Coens C;Messina CG;Bogaerts J;Rutgers EJ
通讯作者：
Rutgers EJ
影响因子：
3.7
作者：
Boccardo, Francesco;Casabona, Federico;Campisi, Corradino
通讯作者：
Campisi, Corradino
影响因子：
3.7
作者：
Boccardo, Francesco M.;Casabona, Federico;Campisi, Corradino
通讯作者：
Campisi, Corradino
影响因子：
1.5
作者：
Johnson, Anna Rose;Kimball, Sarah;Singhal, Dhruv
通讯作者：
Singhal, Dhruv
影响因子：
51.1
作者：
Krag, David N.;Anderson, Stewart J.;Julian, Thomas B.;Brown, Ann M.;Harlow, Seth P.;Costantino, Joseph P.;Ashikaga, Takamaru;Weaver, Donald L.;Mamounas, Eleftherios P.;Jalovec, Lynne M.;Frazier, Thomas G.;Noyes, R. Dirk;Robidoux, Andre;Scarth, Hugh M. C.;Wolmark, Norman
通讯作者：
Wolmark, Norman