Lymphoscintigraphy detecting alterations of upper limb lymphatic flow following early sentinel lymph node biopsy in breast cancer
Identifieur interne : 000406 ( Main/Exploration ); précédent : 000405; suivant : 000407Lymphoscintigraphy detecting alterations of upper limb lymphatic flow following early sentinel lymph node biopsy in breast cancer
Auteurs : Almir Jose Sarri [Brésil] ; Eduardo Tinois Da Silva ; Rene Aloisio Da Costa Vieira ; Katia Hiromoto Koga ; Pedro Henrique Moriguchi Cação ; Vitor Coca Sarri [Brésil] ; Sonia Marta MoriguchiSource :
- Breast Cancer : Targets and Therapy [ 1179-1314 ] ; 2017.
Abstract
To evaluate early variations in lymphatic circulation of the arm pre- and post-sentinel lymph node biopsy (SLNB) and conservative breast surgery by lymphoscintigraphy (LS).
Between 2005 and 2012, 15 patients underwent LS before and after the SLNB (total=30 studies). The pre-SLNB study was considered the control. Early images within twenty minutes (dynamic and static images) and delayed images within ninety minutes of arms and armpits were acquired using a gamma camera. The LS images before and after the SLNB of each patient were paired and compared to each other, evaluating the site of lymphatic flow (in the early phase) and identifying the number of lymph nodes (in the late phase). These dynamic images were subjected to additional quantitative analysis to assess the lymphatic flow rate using the slope assessed by the angular coefficient of the radioactivity × time curves in areas of interest recorded in the axillary region. The variations of lymphatic flow and the number of lymph nodes in the post-SLNB LS compared to the pre-SLNB LS of each patient were classified as decreased, sustained or increased. The clinical variables analyzed included the period between performing the SLNB and the subsequent LS imaging, age, body mass index, number of removed lymph nodes, type of surgery and whether immediate oncoplastic surgery was performed.
The mean age was 54.53±9.03 years (36–73 years), the mean BMI was 27.16±4.16 kg/m2 (19.3–34.42), and the mean number of lymph nodes removed from each patient was 1.6±0.74 (1–3). There was significant difference in the time between surgery and the realization of LS (
Upper limb lymphatic flow gradually decreased after the SLNB and conservative breast surgery in this study, but these results are exploratory because of the small sample size. Further studies are needed to confirm and to investigate more in depth these findings.
Url:
DOI: 10.2147/BCTT.S131407
PubMed: 28458580
PubMed Central: 5402898
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Lymphoscintigraphy detecting alterations of upper limb lymphatic flow following early sentinel lymph node biopsy in breast cancer</title><author><name sortKey="Sarri, Almir Jose" sort="Sarri, Almir Jose" uniqKey="Sarri A" first="Almir Jose" last="Sarri">Almir Jose Sarri</name><affiliation wicri:level="3"><nlm:aff id="af1-bctt-9-279">Department of Physical Therapy, Barretos Cancer Hospital, Barretos, Sao Paulo</nlm:aff><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName><wicri:orgArea>Department of Physical Therapy, Barretos Cancer Hospital, Barretos</wicri:orgArea></affiliation></author><author><name sortKey="Tinois Da Silva, Eduardo" sort="Tinois Da Silva, Eduardo" uniqKey="Tinois Da Silva E" first="Eduardo" last="Tinois Da Silva">Eduardo Tinois Da Silva</name><affiliation><nlm:aff id="af2-bctt-9-279">Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Sao Paulo State University – UNESP, Botucatu</nlm:aff><wicri:noCountry code="subfield">Botucatu</wicri:noCountry></affiliation></author><author><name sortKey="Vieira, Rene Aloisio Da Costa" sort="Vieira, Rene Aloisio Da Costa" uniqKey="Vieira R" first="Rene Aloisio Da Costa" last="Vieira">Rene Aloisio Da Costa Vieira</name><affiliation><nlm:aff id="af3-bctt-9-279">Department of Mastology and Reconstructive Surgery, Barretos Cancer Hospital, Barretos</nlm:aff><wicri:noCountry code="subfield">Barretos</wicri:noCountry></affiliation></author><author><name sortKey="Koga, Katia Hiromoto" sort="Koga, Katia Hiromoto" uniqKey="Koga K" first="Katia Hiromoto" last="Koga">Katia Hiromoto Koga</name><affiliation><nlm:aff id="af2-bctt-9-279">Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Sao Paulo State University – UNESP, Botucatu</nlm:aff><wicri:noCountry 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sort="Moriguchi, Sonia Marta" uniqKey="Moriguchi S" first="Sonia Marta" last="Moriguchi">Sonia Marta Moriguchi</name><affiliation><nlm:aff id="af2-bctt-9-279">Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Sao Paulo State University – UNESP, Botucatu</nlm:aff><wicri:noCountry code="subfield">Botucatu</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28458580</idno><idno type="pmc">5402898</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402898</idno><idno type="RBID">PMC:5402898</idno><idno type="doi">10.2147/BCTT.S131407</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">003C40</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003C40</idno><idno type="wicri:Area/Pmc/Curation">003C39</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">003C39</idno><idno 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type="main">Lymphoscintigraphy detecting alterations of upper limb lymphatic flow following early sentinel lymph node biopsy in breast cancer</title><author><name sortKey="Sarri, Almir Jose" sort="Sarri, Almir Jose" uniqKey="Sarri A" first="Almir Jose" last="Sarri">Almir Jose Sarri</name><affiliation wicri:level="3"><nlm:aff id="af1-bctt-9-279">Department of Physical Therapy, Barretos Cancer Hospital, Barretos, Sao Paulo</nlm:aff><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName><wicri:orgArea>Department of Physical Therapy, Barretos Cancer Hospital, Barretos</wicri:orgArea></affiliation></author><author><name sortKey="Tinois Da Silva, Eduardo" sort="Tinois Da Silva, Eduardo" uniqKey="Tinois Da Silva E" first="Eduardo" last="Tinois Da Silva">Eduardo Tinois Da Silva</name><affiliation><nlm:aff id="af2-bctt-9-279">Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Sao Paulo State University – UNESP, Botucatu</nlm:aff><wicri:noCountry code="subfield">Botucatu</wicri:noCountry></affiliation></author><author><name sortKey="Vieira, Rene Aloisio Da Costa" sort="Vieira, Rene Aloisio Da Costa" uniqKey="Vieira R" first="Rene Aloisio Da Costa" last="Vieira">Rene Aloisio Da Costa Vieira</name><affiliation><nlm:aff id="af3-bctt-9-279">Department of Mastology and Reconstructive Surgery, Barretos Cancer Hospital, Barretos</nlm:aff><wicri:noCountry code="subfield">Barretos</wicri:noCountry></affiliation></author><author><name sortKey="Koga, Katia Hiromoto" sort="Koga, Katia Hiromoto" uniqKey="Koga K" first="Katia Hiromoto" last="Koga">Katia Hiromoto Koga</name><affiliation><nlm:aff id="af2-bctt-9-279">Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Sao Paulo State University – UNESP, Botucatu</nlm:aff><wicri:noCountry code="subfield">Botucatu</wicri:noCountry></affiliation></author><author><name sortKey="Cacao, Pedro Henrique Moriguchi" sort="Cacao, Pedro Henrique Moriguchi" uniqKey="Cacao P" first="Pedro Henrique Moriguchi" last="Cação">Pedro Henrique Moriguchi Cação</name><affiliation><nlm:aff id="af4-bctt-9-279">Department of Radiology – Faculdade de Medicina de São José do Rio Preto (FAMERP)</nlm:aff></affiliation></author><author><name sortKey="Sarri, Vitor Coca" sort="Sarri, Vitor Coca" uniqKey="Sarri V" first="Vitor Coca" last="Sarri">Vitor Coca Sarri</name><affiliation wicri:level="3"><nlm:aff id="af5-bctt-9-279">Medical School, University of Franca, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Medical School, University of Franca, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Moriguchi, Sonia Marta" sort="Moriguchi, Sonia Marta" uniqKey="Moriguchi S" first="Sonia Marta" last="Moriguchi">Sonia Marta Moriguchi</name><affiliation><nlm:aff id="af2-bctt-9-279">Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Sao Paulo State University – UNESP, Botucatu</nlm:aff><wicri:noCountry code="subfield">Botucatu</wicri:noCountry></affiliation></author></analytic><series><title level="j">Breast Cancer : Targets and Therapy</title><idno type="eISSN">1179-1314</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>To evaluate early variations in lymphatic circulation of the arm pre- and post-sentinel lymph node biopsy (SLNB) and conservative breast surgery by lymphoscintigraphy (LS).</p></sec><sec><title>Patients and methods</title><p>Between 2005 and 2012, 15 patients underwent LS before and after the SLNB (total=30 studies). The pre-SLNB study was considered the control. Early images within twenty minutes (dynamic and static images) and delayed images within ninety minutes of arms and armpits were acquired using a gamma camera. The LS images before and after the SLNB of each patient were paired and compared to each other, evaluating the site of lymphatic flow (in the early phase) and identifying the number of lymph nodes (in the late phase). These dynamic images were subjected to additional quantitative analysis to assess the lymphatic flow rate using the slope assessed by the angular coefficient of the radioactivity × time curves in areas of interest recorded in the axillary region. The variations of lymphatic flow and the number of lymph nodes in the post-SLNB LS compared to the pre-SLNB LS of each patient were classified as decreased, sustained or increased. The clinical variables analyzed included the period between performing the SLNB and the subsequent LS imaging, age, body mass index, number of removed lymph nodes, type of surgery and whether immediate oncoplastic surgery was performed.</p></sec><sec><title>Results</title><p>The mean age was 54.53±9.03 years (36–73 years), the mean BMI was 27.16±4.16 kg/m<sup>2</sup> (19.3–34.42), and the mean number of lymph nodes removed from each patient was 1.6±0.74 (1–3). There was significant difference in the time between surgery and the realization of LS (<italic>p</italic>=0.002; Mann–Whitney U test), but in an inverse relationship, the higher was the range, the smaller was the lymphatic flow, indicating a gradual reduction of lymphatic flow after surgery (Spearman’s <italic>p</italic>=0.498, with <italic>p</italic>=0.013).</p></sec><sec><title>Conclusion</title><p>Upper limb lymphatic flow gradually decreased after the SLNB and conservative breast surgery in this study, but these results are exploratory because of the small sample size. 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Halin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dieterich, Lc" uniqKey="Dieterich L">LC Dieterich</name></author><author><name sortKey="Seidel, Cd" uniqKey="Seidel C">CD Seidel</name></author><author><name sortKey="Detmar, M" uniqKey="Detmar M">M Detmar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Miller, Cl" uniqKey="Miller C">CL Miller</name></author><author><name sortKey="Specht, Mc" uniqKey="Specht M">MC Specht</name></author><author><name sortKey="Skolny, Mn" uniqKey="Skolny M">MN Skolny</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Brésil</li></country><region><li>État de São Paulo</li></region><settlement><li>São Paulo</li></settlement></list><tree><noCountry><name sortKey="Cacao, Pedro Henrique Moriguchi" sort="Cacao, Pedro Henrique Moriguchi" uniqKey="Cacao P" first="Pedro Henrique Moriguchi" last="Cação">Pedro Henrique Moriguchi Cação</name><name sortKey="Koga, Katia Hiromoto" sort="Koga, Katia Hiromoto" uniqKey="Koga K" first="Katia Hiromoto" last="Koga">Katia Hiromoto Koga</name><name sortKey="Moriguchi, Sonia Marta" sort="Moriguchi, Sonia Marta" uniqKey="Moriguchi S" first="Sonia Marta" last="Moriguchi">Sonia Marta Moriguchi</name><name sortKey="Tinois Da Silva, Eduardo" sort="Tinois Da Silva, Eduardo" uniqKey="Tinois Da Silva E" first="Eduardo" last="Tinois Da Silva">Eduardo Tinois Da Silva</name><name sortKey="Vieira, Rene Aloisio Da Costa" sort="Vieira, Rene Aloisio Da Costa" uniqKey="Vieira R" first="Rene Aloisio Da Costa" last="Vieira">Rene Aloisio Da Costa Vieira</name></noCountry><country name="Brésil"><region name="État de São Paulo"><name sortKey="Sarri, Almir Jose" sort="Sarri, Almir Jose" uniqKey="Sarri A" first="Almir Jose" last="Sarri">Almir Jose Sarri</name></region><name sortKey="Sarri, Vitor Coca" sort="Sarri, Vitor Coca" uniqKey="Sarri V" first="Vitor Coca" last="Sarri">Vitor Coca 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