Risk of lymphoedema following the treatment of breast cancer
Risk of lymphoedema following the treatment of breast cancer
复制标题
乳腺癌治疗后出现淋巴水肿的风险
作者：
M. Kissin;G. Querci;della Roveret;D. Easton;G. Westbury;M. Kissin
研究人员对 200 名接受各种可手术乳腺癌治疗的患者进行了淋巴水肿的发生率研究。淋巴水肿以两种方式评估：主观（患者加观察者印象）和客观（物理测量）。测量外上髁上方 15 厘米处的手臂体积是评估手术手臂和正常手臂尺寸差异的最准确方法。臂围测量不准确。 14% 的人存在主观淋巴水肿，而 25.5% 的人存在客观淋巴水肿（肢体体积差异 > 200 ml）。导致主观晚期淋巴水肿发生的独立危险因素是腋窝手术范围（P < 0.05）、腋窝放疗（P < 0.001）和病理淋巴结状态（P < 0.10）。发生晚期淋巴水肿的风险与年龄、绝经状态、惯用手、早期淋巴水肿、手术和放疗并发症、辐射总剂量、自就诊时间间隔、药物治疗、乳房手术、乳房放疗和肿瘤T分期无关。单独腋窝放疗（8.3%）、腋窝取样加放疗（9.1%）和单独腋窝清除（7.4%）后主观晚期淋巴水肿的发生率相似。腋窝清除加放疗后的发生率显着更高（38.3%，P < 0.001）。已完成腋窝间隙的患者应避免进行腋窝放射治疗。
The incidence of lymphoedema was studied in 200 patients following a variety of treatments for operable breast cancer. Lymphoedema was assessed in two ways: subjective (patient plus observer impression) and objective (physical measurement). Arm volume measurement 15 cm above the lateral epicondyle was the most accurate method of assessing differences in size of the operated and normal arm. Arm circumference measurements were inaccurate. Subjective lymphoedema was present in 14 per cent whereas objective lymphoedema (a difference in limb volume > 200 ml) was present in 25.5 per cent. Independent risk factors contributing towards the development of subjective late lymphoedema were the extent of axillary surgery (P < 0.05), axillary radiotherapy (P < 0.001) and pathological nodal status (P < 0.10). The risk of developing late lymphoedema was unrelated to age, menopausal status, handedness, early lymphoedema, surgical and radiotherapeutic complications, total dose of radiation, time interval since presentation, drug therapy, surgery to the breast, radiotherapy to the breast and tumour T stage. The incidence of subjective late lymphoedema was similar after axillary radiotherapy alone (8.3 per cent), axillary sampling plus radiotherapy (9.1 percent) and axillary clearance alone (7.4 per cent). The incidence after axillary clearance plus radiotherapy was significantly greater (38.3 per cent, P < 0.001). Axillary radiotherapy should be avoided in patients who have had a total axillary clearance.
影响因子：
158.5
作者：
FISHER, B;REDMOND, C;FOSTER, R
通讯作者：
FOSTER, R
DOI：
10.1001/archsurg.1983.01390050005001
发表时间：
1983
期刊：
Archives of surgery (Chicago, Ill. : 1960)
影响因子：
--
作者：
Romsdahl,MM;Montague,ED;Ames,FC;Richards,PC;Schell,SR
通讯作者：
Schell,SR