Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema
Identifieur interne : 004038 ( Istex/Corpus ); précédent : 004037; suivant : 004039Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema
Auteurs : Russell H. Mellor ; Nigel L. Bush ; Anthony W. B. Stanton ; Jeff C. Bamber ; J. Rodney Levick ; Peter S. MortimerSource :
- The Breast Journal [ 1075-122X ] ; 2004-11.
Abstract
Abstract: Breast cancer‐related lymphedema (BCRL) is a chronic swelling of the arm that sometimes follows breast cancer treatment. Clinically, both skin and subcutis are swollen. Edema is considered to be predominantly subcutaneous and of an even distribution. The purpose of this study was to quantify the degree and uniformity of skin and subcutis swelling around the forearms of women with BCRL. Ten women with BCRL were recruited. Both forearms were examined using 20 MHz ultrasound to visualize the skin and 7 MHz ultrasound to visualize the subcutis. Skin thickness was between the bottom of the entry‐echo and the skin–subcutis boundary. Subcutis thickness was measured between the skin–subcutis boundary and the subcutis–muscle boundary. Both average skin thickness (1.97 ± 1.00 mm) and average subcutis thickness (10.32 ± 5.63 mm) were greater in the ipsilateral arm than in the contralateral arm (skin 1.12 ± 0.14 mm, subcutis 5.58 ± 2.04 mm, p < 0.01, t‐test). The degree of increase in skin thickness did not vary around the arm (p > 0.05, ANOVA), while the degree of increase in subcutis thickness did vary (p < 0.05). Skin thickness correlated negatively with subcutis thickness in the contralateral arm, but correlated positively in the ipsilateral arm. The skin and subcutis are thickened in the ipsilateral arm of patients with BCRL. Skin thickness is increased uniformly around the arm and correlates strongly with the degree of swelling, while subcutis swelling varies. The measurement of skin thickness using ultrasound may form a useful clinical tool in the diagnosis of lymphedema and also aid further investigation of therapeutic techniques.
Url:
DOI: 10.1111/j.1075-122X.2004.21458.x
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Bush</name><affiliation><mods:affiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Stanton, Anthony W B" sort="Stanton, Anthony W B" uniqKey="Stanton A" first="Anthony W. B." last="Stanton">Anthony W. B. Stanton</name><affiliation><mods:affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</mods:affiliation></affiliation></author><author><name sortKey="Bamber, Jeff C" sort="Bamber, Jeff C" uniqKey="Bamber J" first="Jeff C." last="Bamber">Jeff C. Bamber</name><affiliation><mods:affiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Levick, J Rodney" sort="Levick, J Rodney" uniqKey="Levick J" first="J. Rodney" last="Levick">J. Rodney Levick</name><affiliation><mods:affiliation>Department of Physiology, St. George's Hospital Medical School, London</mods:affiliation></affiliation></author><author><name sortKey="Mortimer, Peter S" sort="Mortimer, Peter S" uniqKey="Mortimer P" first="Peter S." last="Mortimer">Peter S. 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Bamber</name><affiliation><mods:affiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Levick, J Rodney" sort="Levick, J Rodney" uniqKey="Levick J" first="J. Rodney" last="Levick">J. Rodney Levick</name><affiliation><mods:affiliation>Department of Physiology, St. George's Hospital Medical School, London</mods:affiliation></affiliation></author><author><name sortKey="Mortimer, Peter S" sort="Mortimer, Peter S" uniqKey="Mortimer P" first="Peter S." last="Mortimer">Peter S. Mortimer</name><affiliation><mods:affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="ISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><imprint><biblScope unit="vol">10</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="496">496</biblScope><biblScope unit="page" to="503">503</biblScope><biblScope unit="page-count">8</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2004-11">2004-11</date></imprint><idno type="ISSN">1075-122X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1075-122X</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Abstract: Breast cancer‐related lymphedema (BCRL) is a chronic swelling of the arm that sometimes follows breast cancer treatment. Clinically, both skin and subcutis are swollen. Edema is considered to be predominantly subcutaneous and of an even distribution. The purpose of this study was to quantify the degree and uniformity of skin and subcutis swelling around the forearms of women with BCRL. Ten women with BCRL were recruited. Both forearms were examined using 20 MHz ultrasound to visualize the skin and 7 MHz ultrasound to visualize the subcutis. Skin thickness was between the bottom of the entry‐echo and the skin–subcutis boundary. Subcutis thickness was measured between the skin–subcutis boundary and the subcutis–muscle boundary. Both average skin thickness (1.97 ± 1.00 mm) and average subcutis thickness (10.32 ± 5.63 mm) were greater in the ipsilateral arm than in the contralateral arm (skin 1.12 ± 0.14 mm, subcutis 5.58 ± 2.04 mm, p < 0.01, t‐test). The degree of increase in skin thickness did not vary around the arm (p > 0.05, ANOVA), while the degree of increase in subcutis thickness did vary (p < 0.05). Skin thickness correlated negatively with subcutis thickness in the contralateral arm, but correlated positively in the ipsilateral arm. The skin and subcutis are thickened in the ipsilateral arm of patients with BCRL. Skin thickness is increased uniformly around the arm and correlates strongly with the degree of swelling, while subcutis swelling varies. The measurement of skin thickness using ultrasound may form a useful clinical tool in the diagnosis of lymphedema and also aid further investigation of therapeutic techniques. </div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>subcutis</json:string><json:string>ipsilateral</json:string><json:string>skin thickness</json:string><json:string>ultrasound</json:string><json:string>contralateral</json:string><json:string>bcrl</json:string><json:string>subcutis thickness</json:string><json:string>ventral</json:string><json:string>dorsal</json:string><json:string>lymphedema</json:string><json:string>mortimer</json:string><json:string>anova</json:string><json:string>medial</json:string><json:string>mellor</json:string><json:string>ventral aspect</json:string><json:string>lymphoedema</json:string><json:string>oedema</json:string><json:string>average skin thickness</json:string><json:string>lateral</json:string><json:string>dorsal aspect</json:string><json:string>forearm</json:string><json:string>vascular sciences</json:string><json:string>medial aspects</json:string><json:string>breast cancer treatment</json:string><json:string>entry echo</json:string><json:string>bcrl patients</json:string><json:string>ipsilateral arms</json:string><json:string>average subcutis thickness</json:string><json:string>lateral aspects</json:string><json:string>dermatology unit</json:string><json:string>breast cancer</json:string><json:string>postmastectomy oedema</json:string></teeft></keywords><author><json:item><name>Russell H. Mellor PhD</name><affiliations><json:string>Department of Cardiac and Vascular Sciences (Dermatology Unit)</json:string><json:string>E-mail: rmellor@sghms.ac.uk</json:string></affiliations></json:item><json:item><name>Nigel L. Bush</name><affiliations><json:string>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</json:string></affiliations></json:item><json:item><name>Anthony W. B. Stanton MBBCh, PhD</name><affiliations><json:string>Department of Cardiac and Vascular Sciences (Dermatology Unit)</json:string></affiliations></json:item><json:item><name>Jeff C. Bamber PhD</name><affiliations><json:string>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</json:string></affiliations></json:item><json:item><name>J. Rodney Levick BMBCh, DPhil, DSc, MRCP(Hon)</name><affiliations><json:string>Department of Physiology, St. George's Hospital Medical School, London</json:string></affiliations></json:item><json:item><name>Peter S. Mortimer MD, FRCP</name><affiliations><json:string>Department of Cardiac and Vascular Sciences (Dermatology Unit)</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>lymphedema</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>skin</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>subcutis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ultrasound</value></json:item></subject><articleId><json:string>TBJ21458</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Abstract: Breast cancer‐related lymphedema (BCRL) is a chronic swelling of the arm that sometimes follows breast cancer treatment. Clinically, both skin and subcutis are swollen. Edema is considered to be predominantly subcutaneous and of an even distribution. The purpose of this study was to quantify the degree and uniformity of skin and subcutis swelling around the forearms of women with BCRL. Ten women with BCRL were recruited. Both forearms were examined using 20 MHz ultrasound to visualize the skin and 7 MHz ultrasound to visualize the subcutis. Skin thickness was between the bottom of the entry‐echo and the skin–subcutis boundary. Subcutis thickness was measured between the skin–subcutis boundary and the subcutis–muscle boundary. Both average skin thickness (1.97 ± 1.00 mm) and average subcutis thickness (10.32 ± 5.63 mm) were greater in the ipsilateral arm than in the contralateral arm (skin 1.12 ± 0.14 mm, subcutis 5.58 ± 2.04 mm, p > 0.01, t‐test). The degree of increase in skin thickness did not vary around the arm (p > 0.05, ANOVA), while the degree of increase in subcutis thickness did vary (p > 0.05). Skin thickness correlated negatively with subcutis thickness in the contralateral arm, but correlated positively in the ipsilateral arm. The skin and subcutis are thickened in the ipsilateral arm of patients with BCRL. Skin thickness is increased uniformly around the arm and correlates strongly with the degree of swelling, while subcutis swelling varies. The measurement of skin thickness using ultrasound may form a useful clinical tool in the diagnosis of lymphedema and also aid further investigation of therapeutic techniques.</abstract><qualityIndicators><score>6.775</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595 x 782 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1666</abstractCharCount><pdfWordCount>3811</pdfWordCount><pdfCharCount>22865</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>247</abstractWordCount></qualityIndicators><title>Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema</title><genre><json:string>article</json:string></genre><host><title>The Breast Journal</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1524-4741</json:string></doi><issn><json:string>1075-122X</json:string></issn><eissn><json:string>1524-4741</json:string></eissn><publisherId><json:string>TBJ</json:string></publisherId><volume>10</volume><issue>6</issue><pages><first>496</first><last>503</last><total>8</total></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>oncology</json:string><json:string>obstetrics & gynecology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>oncology & carcinogenesis</json:string></scienceMetrix></categories><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1111/j.1075-122X.2004.21458.x</json:string></doi><id>885B30FC58BD8B8A3CC1D7726622FA5B500EAEDC</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/885B30FC58BD8B8A3CC1D7726622FA5B500EAEDC/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/885B30FC58BD8B8A3CC1D7726622FA5B500EAEDC/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/885B30FC58BD8B8A3CC1D7726622FA5B500EAEDC/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema</title></titleStmt><publicationStmt><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2004-11"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema</title><title level="a" type="short">Skin and Subcutis Thickness in BCRL</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Russell H.</forename><surname>Mellor</surname><roleName type="degree">PhD</roleName></persName><affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</affiliation><affiliation>Address correspondence and reprint requests to: R. H. Mellor, PhD, Department of Cardiac and Vascular Sciences (Dermatology Unit), St. George's Hospital Medical School, Cranmer Terrace, London, SW17 0RE, UK, or e‐mail: rmellor@sghms.ac.uk.</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Nigel L.</forename><surname>Bush</surname></persName><affiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom<address><country key="GB"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Anthony W. B.</forename><surname>Stanton</surname><roleName type="degree">MBBCh, PhD</roleName></persName><affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Jeff C.</forename><surname>Bamber</surname><roleName type="degree">PhD</roleName></persName><affiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom<address><country key="GB"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">J. Rodney</forename><surname>Levick</surname><roleName type="degree">BMBCh, DPhil, DSc, MRCP(Hon)</roleName></persName><affiliation>Department of Physiology, St. George's Hospital Medical School, London</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Peter S.</forename><surname>Mortimer</surname><roleName type="degree">MD, FRCP</roleName></persName><affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</affiliation></author><idno type="istex">885B30FC58BD8B8A3CC1D7726622FA5B500EAEDC</idno><idno type="DOI">10.1111/j.1075-122X.2004.21458.x</idno><idno type="unit">TBJ21458</idno><idno type="toTypesetVersion">file:TBJ.TBJ21458.pdf</idno></analytic><monogr><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="pISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><idno type="book-DOI">10.1111/(ISSN)1524-4741</idno><idno type="book-part-DOI">10.1111/tbj.2004.10.issue-6</idno><idno type="product">TBJ</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">10</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="496">496</biblScope><biblScope unit="page" to="503">503</biblScope><biblScope unit="page-count">8</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2004-11"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">Abstract: </hi> Breast cancer‐related lymphedema (BCRL) is a chronic swelling of the arm that sometimes follows breast cancer treatment. Clinically, both skin and subcutis are swollen. Edema is considered to be predominantly subcutaneous and of an even distribution. The purpose of this study was to quantify the degree and uniformity of skin and subcutis swelling around the forearms of women with BCRL. Ten women with BCRL were recruited. Both forearms were examined using 20 MHz ultrasound to visualize the skin and 7 MHz ultrasound to visualize the subcutis. Skin thickness was between the bottom of the entry‐echo and the skin–subcutis boundary. Subcutis thickness was measured between the skin–subcutis boundary and the subcutis–muscle boundary. Both average skin thickness (1.97 ± 1.00 mm) and average subcutis thickness (10.32 ± 5.63 mm) were greater in the ipsilateral arm than in the contralateral arm (skin 1.12 ± 0.14 mm, subcutis 5.58 ± 2.04 mm, <hi rend="italic">p</hi> < 0.01, <hi rend="italic">t</hi>‐test). The degree of increase in skin thickness did not vary around the arm (<hi rend="italic">p</hi> > 0.05, ANOVA), while the degree of increase in subcutis thickness did vary (<hi rend="italic">p</hi> < 0.05). Skin thickness correlated negatively with subcutis thickness in the contralateral arm, but correlated positively in the ipsilateral arm. The skin and subcutis are thickened in the ipsilateral arm of patients with BCRL. Skin thickness is increased uniformly around the arm and correlates strongly with the degree of swelling, while subcutis swelling varies. The measurement of skin thickness using ultrasound may form a useful clinical tool in the diagnosis of lymphedema and also aid further investigation of therapeutic techniques. </p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">lymphedema</term><term xml:id="k2">skin</term><term xml:id="k3">subcutis</term><term xml:id="k4">ultrasound </term></keywords><classCode scheme="tocHeading1">ORIGINAL ARTICLES</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/885B30FC58BD8B8A3CC1D7726622FA5B500EAEDC/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Science Inc</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1524-4741</doi><issn type="print">1075-122X</issn><issn type="electronic">1524-4741</issn><idGroup><id type="product" value="TBJ"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="BREAST JOURNAL">The Breast Journal</title></titleGroup></publicationMeta><publicationMeta level="part" position="11006"><doi origin="wiley">10.1111/tbj.2004.10.issue-6</doi><numberingGroup><numbering type="journalVolume" number="10">10</numbering><numbering type="journalIssue" number="6">6</numbering></numberingGroup><coverDate startDate="2004-11">November 2004</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="6" status="forIssue"><doi origin="wiley">10.1111/j.1075-122X.2004.21458.x</doi><idGroup><id type="unit" value="TBJ21458"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title></titleGroup><eventGroup><event type="firstOnline" date="2004-11-01"></event><event type="publishedOnlineFinalForm" date="2004-11-01"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-04"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-10"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-04"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="496">496</numbering><numbering type="pageLast" number="503">503</numbering></numberingGroup><correspondenceTo>Address correspondence and reprint requests to: R. 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Mellor, PhD, Department of Cardiac and Vascular Sciences (Dermatology Unit), St. George's Hospital Medical School, Cranmer Terrace, London, SW17 0RE, UK, or e‐mail: <email>rmellor@sghms.ac.uk</email>.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:TBJ.TBJ21458.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="6"></count><count type="tableTotal" number="2"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="30"></count><count type="wordTotal" number="3191"></count></countGroup><titleGroup><title type="main">Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema</title><title type="shortAuthors"><sc>mellor et al.</sc></title><title type="short"><i>Skin and Subcutis Thickness in BCRL</i></title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>Russell H.</givenNames><familyName>Mellor</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>Nigel L.</givenNames><familyName>Bush</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>Anthony W. B.</givenNames><familyName>Stanton</familyName><degrees>MBBCh, PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a2"><personName><givenNames>Jeff C.</givenNames><familyName>Bamber</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a3"><personName><givenNames>J. Rodney</givenNames><familyName>Levick</familyName><degrees>BMBCh, DPhil, DSc, MRCP(Hon)</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>Peter S.</givenNames><familyName>Mortimer</familyName><degrees>MD, FRCP</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</unparsedAffiliation></affiliation><affiliation xml:id="a3"><unparsedAffiliation>Department of Physiology, St. George's Hospital Medical School, London</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="GB"><unparsedAffiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">lymphedema</keyword><keyword xml:id="k2">skin</keyword><keyword xml:id="k3">subcutis</keyword><keyword xml:id="k4">ultrasound </keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Abstract: </b> Breast cancer‐related lymphedema (BCRL) is a chronic swelling of the arm that sometimes follows breast cancer treatment. Clinically, both skin and subcutis are swollen. Edema is considered to be predominantly subcutaneous and of an even distribution. The purpose of this study was to quantify the degree and uniformity of skin and subcutis swelling around the forearms of women with BCRL. Ten women with BCRL were recruited. Both forearms were examined using 20 MHz ultrasound to visualize the skin and 7 MHz ultrasound to visualize the subcutis. Skin thickness was between the bottom of the entry‐echo and the skin–subcutis boundary. Subcutis thickness was measured between the skin–subcutis boundary and the subcutis–muscle boundary. Both average skin thickness (1.97 ± 1.00 mm) and average subcutis thickness (10.32 ± 5.63 mm) were greater in the ipsilateral arm than in the contralateral arm (skin 1.12 ± 0.14 mm, subcutis 5.58 ± 2.04 mm, <i>p</i> < 0.01, <i>t</i>‐test). The degree of increase in skin thickness did not vary around the arm (<i>p</i> > 0.05, ANOVA), while the degree of increase in subcutis thickness did vary (<i>p</i> < 0.05). Skin thickness correlated negatively with subcutis thickness in the contralateral arm, but correlated positively in the ipsilateral arm. The skin and subcutis are thickened in the ipsilateral arm of patients with BCRL. Skin thickness is increased uniformly around the arm and correlates strongly with the degree of swelling, while subcutis swelling varies. The measurement of skin thickness using ultrasound may form a useful clinical tool in the diagnosis of lymphedema and also aid further investigation of therapeutic techniques. </p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Skin and Subcutis Thickness in BCRL</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Dual‐Frequency Ultrasound Examination of Skin and Subcutis Thickness in Breast Cancer‐Related Lymphedema</title></titleInfo><name type="personal"><namePart type="given">Russell H.</namePart><namePart type="family">Mellor</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</affiliation><affiliation>E-mail: rmellor@sghms.ac.uk</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nigel L.</namePart><namePart type="family">Bush</namePart><affiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Anthony W. B.</namePart><namePart type="family">Stanton</namePart><namePart type="termsOfAddress">MBBCh, PhD</namePart><affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jeff C.</namePart><namePart type="family">Bamber</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J. Rodney</namePart><namePart type="family">Levick</namePart><namePart type="termsOfAddress">BMBCh, DPhil, DSc, MRCP(Hon)</namePart><affiliation>Department of Physiology, St. George's Hospital Medical School, London</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Peter S.</namePart><namePart type="family">Mortimer</namePart><namePart type="termsOfAddress">MD, FRCP</namePart><affiliation>Department of Cardiac and Vascular Sciences (Dermatology Unit)</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Science Inc</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2004-11</dateIssued><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">6</extent><extent unit="tables">2</extent><extent unit="references">30</extent><extent unit="words">3191</extent></physicalDescription><abstract>Abstract: Breast cancer‐related lymphedema (BCRL) is a chronic swelling of the arm that sometimes follows breast cancer treatment. Clinically, both skin and subcutis are swollen. Edema is considered to be predominantly subcutaneous and of an even distribution. The purpose of this study was to quantify the degree and uniformity of skin and subcutis swelling around the forearms of women with BCRL. Ten women with BCRL were recruited. Both forearms were examined using 20 MHz ultrasound to visualize the skin and 7 MHz ultrasound to visualize the subcutis. Skin thickness was between the bottom of the entry‐echo and the skin–subcutis boundary. Subcutis thickness was measured between the skin–subcutis boundary and the subcutis–muscle boundary. Both average skin thickness (1.97 ± 1.00 mm) and average subcutis thickness (10.32 ± 5.63 mm) were greater in the ipsilateral arm than in the contralateral arm (skin 1.12 ± 0.14 mm, subcutis 5.58 ± 2.04 mm, p < 0.01, t‐test). The degree of increase in skin thickness did not vary around the arm (p > 0.05, ANOVA), while the degree of increase in subcutis thickness did vary (p < 0.05). Skin thickness correlated negatively with subcutis thickness in the contralateral arm, but correlated positively in the ipsilateral arm. The skin and subcutis are thickened in the ipsilateral arm of patients with BCRL. Skin thickness is increased uniformly around the arm and correlates strongly with the degree of swelling, while subcutis swelling varies. The measurement of skin thickness using ultrasound may form a useful clinical tool in the diagnosis of lymphedema and also aid further investigation of therapeutic techniques. </abstract><subject lang="en"><genre>keywords</genre><topic>lymphedema</topic><topic>skin</topic><topic>subcutis</topic><topic>ultrasound</topic></subject><relatedItem type="host"><titleInfo><title>The Breast Journal</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1075-122X</identifier><identifier type="eISSN">1524-4741</identifier><identifier type="DOI">10.1111/(ISSN)1524-4741</identifier><identifier type="PublisherID">TBJ</identifier><part><date>2004</date><detail type="volume"><caption>vol.</caption><number>10</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>496</start><end>503</end><total>8</total></extent></part></relatedItem><identifier type="istex">885B30FC58BD8B8A3CC1D7726622FA5B500EAEDC</identifier><identifier type="DOI">10.1111/j.1075-122X.2004.21458.x</identifier><identifier type="ArticleID">TBJ21458</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Science Inc</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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