LymphedemaV1, Main, Exploration, bibRecord, 008E80

Impairment of Lymph Drainage in Subfascial Compartment of Forearm in Breast Cancer-Related Lymphedema

Identifieur interne : 008E80 ( Main/Exploration ); précédent : 008E79; suivant : 008E81

Impairment of Lymph Drainage in Subfascial Compartment of Forearm in Breast Cancer-Related Lymphedema

Auteurs : A. W. B. Stanton ; R. H. Mellor ; G. J. Cook ; W. E. Svensson ; A. M. Peters ; J. R. Levick [Royaume-Uni] ; Peter Mortimer (dermatologue)‎ [Royaume-Uni]

Source :

Lymphatic research and biology [ 1539-6851 ] ; 2003.

RBID : PMC:1351042

Descripteurs français

KwdFr :
- Adulte d'âge moyen, Avant-bras (anatomopathologie), Caméras à rayons gamma, Drainage, Facteurs temps, Femelle, Humains, Immunoglobuline G (métabolisme), Lymphadénectomie, Lymphe (métabolisme), Lymphe (physiologie), Lymphoedème (anatomopathologie), Lymphoedème (étiologie), Lymphographie (), Mastectomie radicale modifiée, Muscles (anatomopathologie), Noeuds lymphatiques (anatomopathologie), Scintigraphie (), Sujet âgé, Système lymphatique (anatomopathologie), Technétium (pharmacocinétique), Température, Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Vaisseaux lymphatiques (anatomopathologie).
MESH :
- anatomopathologie : Avant-bras, Lymphoedème, Muscles, Noeuds lymphatiques, Système lymphatique, Tumeurs du sein, Vaisseaux lymphatiques.
- métabolisme : Immunoglobuline G, Lymphe.
- pharmacocinétique : Technétium.
- physiologie : Lymphe.
- étiologie : Lymphoedème.
- Adulte d'âge moyen, Caméras à rayons gamma, Drainage, Facteurs temps, Femelle, Humains, Lymphadénectomie, Lymphographie, Mastectomie radicale modifiée, Scintigraphie, Sujet âgé, Température, Tumeurs du sein.

English descriptors

KwdEn :
- Aged, Breast Neoplasms (complications), Breast Neoplasms (pathology), Drainage, Female, Forearm (pathology), Gamma Cameras, Humans, Immunoglobulin G (metabolism), Lymph (metabolism), Lymph (physiology), Lymph Node Excision, Lymph Nodes (pathology), Lymphatic System (pathology), Lymphatic Vessels (pathology), Lymphedema (etiology), Lymphedema (pathology), Lymphography (methods), Mastectomy, Modified Radical, Middle Aged, Muscles (pathology), Radionuclide Imaging (methods), Technetium (pharmacokinetics), Temperature, Time Factors.
MESH :
- chemical , metabolism : Immunoglobulin G.
- complications : Breast Neoplasms.
- etiology : Lymphedema.
- metabolism : Lymph.
- methods : Lymphography, Radionuclide Imaging.
- pathology : Breast Neoplasms, Forearm, Lymph Nodes, Lymphatic System, Lymphatic Vessels, Lymphedema, Muscles.
- chemical , pharmacokinetics : Technetium.
- physiology : Lymph.
- Aged, Drainage, Female, Gamma Cameras, Humans, Lymph Node Excision, Mastectomy, Modified Radical, Middle Aged, Temperature, Time Factors.

Abstract

Background: In arm lymphedema secondary to axillary surgery and radiotherapy (breast cancer-related lymphedema), the swelling is largely epifascial and lymph flow per unit epifascial volume is impaired. The subfascial muscle compartment is not measurably swollen despite the iatrogenic damage to its axillary drainage pathway, but this could be due to its low compliance. Our aim was to test the hypothesis that subfascial lymph drainage too is impaired.

Methods and Results: Quantitative lymphoscintigraphy was used to measure the removal rate constant (local lymph flow per unit distribution volume) for technetium-99m-human immunoglobulin G injected intramuscularly in the forearms of nine women with unilateral lymphedema. The removal rate constant was on average 31% lower in the ipsilateral swollen forearm than in the contralateral forearm (swollen arm: −0.096 ± 0.041% min⁻¹, contralateralarm: −0.138 ± 0.037% min⁻¹; mean ± SD, p = 0.037). The decrease in subfascial rate constant correlated strongly with increase in arm volume (r 0.88, p = 0.002), even though the swelling is mainly epifascial. There was no convincing evidence of dermal backflow.

Conclusions: Lymph flow in the subfascial muscle compartment is decreased in breast cancer-related lymphedema. The correlation between impairment of subfascial drainage and epifascial arm swelling could be because both depend on the severity of axillary damage, or because loss of function in subfascial lymphatics impairs drainage from the epifascial to the subfascial system.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351042

PubMed: 15624420
PubMed Central: 1351042

Affiliations:

Le document en format XML

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<wicri:noCountry code="subfield">London.</wicri:noCountry>
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<affiliation><nlm:aff id="A1">Division of Physiological Medicine (Dermatology), Department of Medicine, St George's Hospital Medical School, London.</nlm:aff>
<wicri:noCountry code="subfield">London.</wicri:noCountry>
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<wicri:noCountry code="subfield">Surrey.</wicri:noCountry>
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<wicri:noCountry code="subfield">London.</wicri:noCountry>
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<wicri:noCountry code="subfield">Cambridge.</wicri:noCountry>
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<author><name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P. S." last="Mortimer">Peter Mortimer (dermatologue)‎</name>
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<wicri:noCountry code="subfield">London.</wicri:noCountry>
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<series><title level="j">Lymphatic research and biology</title>
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<idno type="eISSN">1557-8585</idno>
<imprint><date when="2003">2003</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Breast Neoplasms (complications)</term>
<term>Breast Neoplasms (pathology)</term>
<term>Drainage</term>
<term>Female</term>
<term>Forearm (pathology)</term>
<term>Gamma Cameras</term>
<term>Humans</term>
<term>Immunoglobulin G (metabolism)</term>
<term>Lymph (metabolism)</term>
<term>Lymph (physiology)</term>
<term>Lymph Node Excision</term>
<term>Lymph Nodes (pathology)</term>
<term>Lymphatic System (pathology)</term>
<term>Lymphatic Vessels (pathology)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (pathology)</term>
<term>Lymphography (methods)</term>
<term>Mastectomy, Modified Radical</term>
<term>Middle Aged</term>
<term>Muscles (pathology)</term>
<term>Radionuclide Imaging (methods)</term>
<term>Technetium (pharmacokinetics)</term>
<term>Temperature</term>
<term>Time Factors</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Avant-bras (anatomopathologie)</term>
<term>Caméras à rayons gamma</term>
<term>Drainage</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Immunoglobuline G (métabolisme)</term>
<term>Lymphadénectomie</term>
<term>Lymphe (métabolisme)</term>
<term>Lymphe (physiologie)</term>
<term>Lymphoedème (anatomopathologie)</term>
<term>Lymphoedème (étiologie)</term>
<term>Lymphographie ()</term>
<term>Mastectomie radicale modifiée</term>
<term>Muscles (anatomopathologie)</term>
<term>Noeuds lymphatiques (anatomopathologie)</term>
<term>Scintigraphie ()</term>
<term>Sujet âgé</term>
<term>Système lymphatique (anatomopathologie)</term>
<term>Technétium (pharmacocinétique)</term>
<term>Température</term>
<term>Tumeurs du sein ()</term>
<term>Tumeurs du sein (anatomopathologie)</term>
<term>Vaisseaux lymphatiques (anatomopathologie)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Immunoglobulin G</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Avant-bras</term>
<term>Lymphoedème</term>
<term>Muscles</term>
<term>Noeuds lymphatiques</term>
<term>Système lymphatique</term>
<term>Tumeurs du sein</term>
<term>Vaisseaux lymphatiques</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Lymph</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymphography</term>
<term>Radionuclide Imaging</term>
</keywords>
<keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Immunoglobuline G</term>
<term>Lymphe</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term>
<term>Forearm</term>
<term>Lymph Nodes</term>
<term>Lymphatic System</term>
<term>Lymphatic Vessels</term>
<term>Lymphedema</term>
<term>Muscles</term>
</keywords>
<keywords scheme="MESH" qualifier="pharmacocinétique" xml:lang="fr"><term>Technétium</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="pharmacokinetics" xml:lang="en"><term>Technetium</term>
</keywords>
<keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Lymphe</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Lymph</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Drainage</term>
<term>Female</term>
<term>Gamma Cameras</term>
<term>Humans</term>
<term>Lymph Node Excision</term>
<term>Mastectomy, Modified Radical</term>
<term>Middle Aged</term>
<term>Temperature</term>
<term>Time Factors</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Caméras à rayons gamma</term>
<term>Drainage</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphadénectomie</term>
<term>Lymphographie</term>
<term>Mastectomie radicale modifiée</term>
<term>Scintigraphie</term>
<term>Sujet âgé</term>
<term>Température</term>
<term>Tumeurs du sein</term>
</keywords>
</textClass>
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</teiHeader>
<front><div type="abstract" xml:lang="en"><p id="P1"><italic>Background</italic>
: In arm lymphedema secondary to axillary surgery and radiotherapy (breast cancer-related lymphedema), the swelling is largely epifascial and lymph flow per unit epifascial volume is impaired. The subfascial muscle compartment is not measurably swollen despite the iatrogenic damage to its axillary drainage pathway, but this could be due to its low compliance. Our aim was to test the hypothesis that subfascial lymph drainage too is impaired.</p>
<p id="P2"><italic>Methods and Results</italic>
: Quantitative lymphoscintigraphy was used to measure the removal rate constant (local lymph flow per unit distribution volume) for technetium-99m-human immunoglobulin G injected intramuscularly in the forearms of nine women with unilateral lymphedema. The removal rate constant was on average 31% lower in the ipsilateral swollen forearm than in the contralateral forearm (swollen arm: −0.096 ± 0.041% min<sup>−1</sup>
, contralateralarm: −0.138 ± 0.037% min<sup>−1</sup>
; mean ± SD, p = 0.037). The decrease in subfascial rate constant correlated strongly with increase in arm volume (<italic>r</italic>
 0.88, p = 0.002), even though the swelling is mainly epifascial. There was no convincing evidence of dermal backflow.</p>
<p id="P3"><italic>Conclusions</italic>
: Lymph flow in the subfascial muscle compartment is decreased in breast cancer-related lymphedema. The correlation between impairment of subfascial drainage and epifascial arm swelling could be because both depend on the severity of axillary damage, or because loss of function in subfascial lymphatics impairs drainage from the epifascial to the subfascial system.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Royaume-Uni</li>
</country>
<region><li>Angleterre</li>
<li>Grand Londres</li>
</region>
<settlement><li>Londres</li>
</settlement>
<orgName><li>Université de Londres</li>
</orgName>
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<tree><noCountry><name sortKey="Cook, G J" sort="Cook, G J" uniqKey="Cook G" first="G. J." last="Cook">G. J. Cook</name>
<name sortKey="Mellor, R H" sort="Mellor, R H" uniqKey="Mellor R" first="R. H." last="Mellor">R. H. Mellor</name>
<name sortKey="Peters, A M" sort="Peters, A M" uniqKey="Peters A" first="A. M." last="Peters">A. M. Peters</name>
<name sortKey="Stanton, A W B" sort="Stanton, A W B" uniqKey="Stanton A" first="A. W. B." last="Stanton">A. W. B. Stanton</name>
<name sortKey="Svensson, W E" sort="Svensson, W E" uniqKey="Svensson W" first="W. E." last="Svensson">W. E. Svensson</name>
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<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Levick, J R" sort="Levick, J R" uniqKey="Levick J" first="J. R." last="Levick">J. R. Levick</name>
</region>
<name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P. S." last="Mortimer">Peter Mortimer (dermatologue)‎</name>
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Serveur d'exploration sur le lymphœdème

Impairment of Lymph Drainage in Subfascial Compartment of Forearm in Breast Cancer-Related Lymphedema

Impairment of Lymph Drainage in Subfascial Compartment of Forearm in Breast Cancer-Related Lymphedema

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Descripteurs français

English descriptors

Abstract

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