Serveur d'exploration sur le lymphœdème

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Comparison of lymphedema in patients with axillary lymph node dissections to those with sentinel lymph node biopsy followed by immediate and delayed ALND.

Identifieur interne : 002354 ( PubMed/Curation ); précédent : 002353; suivant : 002355

Comparison of lymphedema in patients with axillary lymph node dissections to those with sentinel lymph node biopsy followed by immediate and delayed ALND.

Auteurs : Nafisa Kayam Kuwajerwala [États-Unis] ; Claire Feczko ; Nayana Dekhne ; Jane Pettinga ; Victoria C. Lucia ; Justin Riutta ; Frank Vicini

Source :

RBID : pubmed:22157215

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English descriptors

Abstract

The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital.

DOI: 10.1097/COC.0b013e31823a4956
PubMed: 22157215

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pubmed:22157215

Le document en format XML

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<title xml:lang="en">Comparison of lymphedema in patients with axillary lymph node dissections to those with sentinel lymph node biopsy followed by immediate and delayed ALND.</title>
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<name sortKey="Kuwajerwala, Nafisa Kayam" sort="Kuwajerwala, Nafisa Kayam" uniqKey="Kuwajerwala N" first="Nafisa Kayam" last="Kuwajerwala">Nafisa Kayam Kuwajerwala</name>
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<nlm:affiliation>Department of Surgery, William Beaumont Hospital, Royal Oak, MI, USA.</nlm:affiliation>
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<name sortKey="Feczko, Claire" sort="Feczko, Claire" uniqKey="Feczko C" first="Claire" last="Feczko">Claire Feczko</name>
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<name sortKey="Dekhne, Nayana" sort="Dekhne, Nayana" uniqKey="Dekhne N" first="Nayana" last="Dekhne">Nayana Dekhne</name>
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<name sortKey="Pettinga, Jane" sort="Pettinga, Jane" uniqKey="Pettinga J" first="Jane" last="Pettinga">Jane Pettinga</name>
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<name sortKey="Lucia, Victoria C" sort="Lucia, Victoria C" uniqKey="Lucia V" first="Victoria C" last="Lucia">Victoria C. Lucia</name>
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<name sortKey="Riutta, Justin" sort="Riutta, Justin" uniqKey="Riutta J" first="Justin" last="Riutta">Justin Riutta</name>
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<term>Breast Neoplasms (surgery)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Incidence</term>
<term>Lymph Node Excision (adverse effects)</term>
<term>Lymph Node Excision (methods)</term>
<term>Lymphedema (epidemiology)</term>
<term>Lymphedema (etiology)</term>
<term>Sentinel Lymph Node Biopsy (adverse effects)</term>
<term>Time Factors</term>
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<keywords scheme="KwdFr" xml:lang="fr">
<term>Biopsie de noeud lymphatique sentinelle (effets indésirables)</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Incidence</term>
<term>Lymphadénectomie ()</term>
<term>Lymphadénectomie (effets indésirables)</term>
<term>Lymphoedème (épidémiologie)</term>
<term>Lymphoedème (étiologie)</term>
<term>Tumeurs du sein ()</term>
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<term>Lymph Node Excision</term>
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<term>Biopsie de noeud lymphatique sentinelle</term>
<term>Lymphadénectomie</term>
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<term>Lymphedema</term>
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<term>Lymphedema</term>
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<term>Lymph Node Excision</term>
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<front>
<div type="abstract" xml:lang="en">The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital.</div>
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<Month>01</Month>
<Day>21</Day>
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<Year>2013</Year>
<Month>03</Month>
<Day>29</Day>
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<Title>American journal of clinical oncology</Title>
<ISOAbbreviation>Am. J. Clin. Oncol.</ISOAbbreviation>
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<ArticleTitle>Comparison of lymphedema in patients with axillary lymph node dissections to those with sentinel lymph node biopsy followed by immediate and delayed ALND.</ArticleTitle>
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<AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital.</AbstractText>
<AbstractText Label="METHOD" NlmCategory="METHODS">NSABP B-32 at Beaumont had 207 patients with follow-up data on 199 patients, randomizing clinically negative axilla to sentinel lymph node biopsy (SLNB)+ALND (GrA N=98), and SLNB+cytology±ALND (GrB N=101). All patients had preoperative volumetric arm measurements and only node negatives had routine postoperative measurements assessing lymphedema for 36 months. We contacted node-positive patients for postoperative measurements for this study. Twenty-four and 15 cytology-positive patients had SLNB+ALND in GrA and GrB, respectively (SubGrA1 N=24; SubGrB1 N=15). Fourteen hematoxylin and eosin-positive patients had delayed ALND (SubGrB2a N=14).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Lymphedema rate for node-positive SLNB+ALND was 10.3% [SubGrA1 (3/24)+SubGrB1 (1/15)=4/39] and node-negative SLNB+ALND was 6.8% (SubGrA2=5/74). Lymphedema was 14.3% for delayed ALND in SubGrB2a (2 of 14) and 0% for 72 SLNBs in SubGrB2b. Our study comparing immediate and delayed ALND lymphedema was not statistically significant (10.3% vs. 14.3%, P=0.65). Comparing node-negative ALND (SubGrA2= 5/74=6.8%) to node-positive ALND (A1+B1+B2a=6/53=11.3%) was not statistically significant (P=0.52). Comparing lymphedema for node-negative ALND (SubGrA2) to SLNB (SubGrB2b) only approached significance (6.8% vs. 0%, P=0.058).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.</AbstractText>
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