Breast cancer-related arm lymphedema: incidence rates, diagnostic techniques, optimal management and risk reduction strategies.
Identifieur interne : 005043 ( Main/Exploration ); précédent : 005042; suivant : 005044Breast cancer-related arm lymphedema: incidence rates, diagnostic techniques, optimal management and risk reduction strategies.
Auteurs : Chirag Shah [États-Unis] ; Frank A. ViciniSource :
- International journal of radiation oncology, biology, physics [ 1879-355X ] ; 2011.
Descripteurs français
- KwdFr :
- MESH :
- diagnostic : Lymphoedème.
- effets indésirables : Lymphadénectomie, Mastectomie.
- épidémiologie : Lymphoedème.
- étiologie : Lymphoedème.
- Aisselle, Femelle, Humains, Incidence, Lymphoedème, Tumeurs du sein.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Lymph Node Excision, Mastectomy.
- diagnosis : Lymphedema.
- epidemiology : Lymphedema.
- etiology : Lymphedema.
- therapy : Breast Neoplasms, Lymphedema.
- Axilla, Female, Humans, Incidence.
Abstract
As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.
DOI: 10.1016/j.ijrobp.2011.05.043
PubMed: 21945108
Affiliations:
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Vicini</name></author></analytic><series><title level="j">International journal of radiation oncology, biology, physics</title><idno type="eISSN">1879-355X</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla</term><term>Breast Neoplasms (therapy)</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Lymph Node Excision (adverse effects)</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (etiology)</term><term>Lymphedema (therapy)</term><term>Mastectomy (adverse effects)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Aisselle</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphoedème ()</term><term>Lymphoedème (diagnostic)</term><term>Lymphoedème (épidémiologie)</term><term>Lymphoedème (étiologie)</term><term>Mastectomie (effets indésirables)</term><term>Tumeurs du sein ()</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term><term>Mastectomy</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term><term>Mastectomie</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Axilla</term><term>Female</term><term>Humans</term><term>Incidence</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Aisselle</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Lymphoedème</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li></region></list><tree><noCountry><name sortKey="Vicini, Frank A" sort="Vicini, Frank A" uniqKey="Vicini F" first="Frank A" last="Vicini">Frank A. Vicini</name></noCountry><country name="États-Unis"><region name="Michigan"><name sortKey="Shah, Chirag" sort="Shah, Chirag" uniqKey="Shah C" first="Chirag" last="Shah">Chirag Shah</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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