Prevalence of lymphedema in women undergoing treatment for breast cancer in a referral center in southeastern Brazil

Article (PDF Available)inBMC Women's Health 13(1):6 · February 2013with40 Reads
DOI: 10.1186/1472-6874-13-6 · Source: PubMed
Abstract Background Lymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life. The objective of this study was to estimate the prevalence of lymphedema and associated factors in women treated for breast cancer in the municipality of Juiz de Fora. Methods We performed a cross-sectional study that evaluated 250 women who were being treated for breast cancer. Pre-screening of the sample by analysis of medical records was performed to select women who met the inclusion criteria as follows: women who had an operation more than 6 months ago; absence of active disease, locoregional or distant; the absence of functional change in the affected limb before surgery, which could lead to swelling of the limb; and simulating or masking symptoms of lymphedema, such as bursitis, tendonitis, and work-related musculoskeletal disorders. Women with bilateral breast cancer, absence of axillary intervention (partial or complete axillary dissection and/or SLN biopsy), active disease in the region, or lympho-venous alteration of the limb before surgery were excluded. Data were collected from the medical records of the selected cases, and they subsequently underwent an interview and a physical assessment. Results The prevalence of lymphedema was 44.8%. There were medical records on the presence of this condition in 5.4% of cases. With regard to shoulder joint mobility, restrictions on abduction movements, internal and external rotation, and anterior shoulder adduction were significantly associated with lymphedema. Variables, including the presence of seroma, vascular changes, time elapsed after surgery, episodes of redness in the extremities, and cuticle removal from the hand with pliers were considered as major associated factors for lymphedema (p
    • "Outra limitação está na utilização apenas da perimetria como técnica de mensuração do linfedema. Apesar de utilizada [6,12,25], sabe-se que a técnica de perimetria do membro possui algumas limitações, tais como baixa reprodutibilidade [14]. Em relação ao diagnóstico de linfedema, a comparação entre métodos objetivos -perimetria e volume estimado do membro-mostrou que a perimetria com medidas de circunferência aferidas a cada 2,5 cm é o método com maior sensibilidade (74%), e especificidade (98%) [29]. "
    Full-text · Article · Jan 2015 · Supportive Care Cancer
  • [Show abstract] [Hide abstract] ABSTRACT: Wstęp: Celem pracy była ocena skuteczności drenażu limfatycznego stosowanego w czasie dwutygodniowej terapii ambulatoryjnej u pacjentek po mastektomii z uwzględnieniem takich cech jak: lokalizacja obrzęku, wiek pacjentki, wskaźnik masy ciała BMI oraz zmiany jakości życia w wymiarze fizycznym i mentalnym.Materiał i metody: Badanie przeprowadzono wśród 52 kobiet po zabiegu mastektomii, leczonych ambulatoryjnie. Skuteczność drenażu limfatycznego oceniono dokonując pomiarów linijnych kończyn górnych na sześciu poziomach przed i po dwutygodniowej serii zabiegów. W badaniu wykorzystano sondaż diagnostyczny oraz kwestionariusz jakości życia SF-36. Wyniki: Wyniki badań potwierdzają istotny wpływ uwzględnionych czynników na skuteczność terapii manualnym drenażem limfatycznym. Największe zróżnicowanie w skuteczności drenażu widoczne było w analizie BMI, umiejscowienia obrzęku oraz wymiaru fizycznego jakości życia. Skuteczność drenażu limfatycznego malała wraz ze wzrostem współczynnika masy ciała oraz wiekiem pacjentek. Wnioski: Manualny drenaż limfatyczny stosowany u kobiet po mastektomii w istotny sposób wpłynął na zmniejszenie następstw pooperacyjnych zarówno w aspekcie sprawności fizycznej, stanu psychicznego, jak również w sferze poprawy jakości życia. Effectiveness of the lymphatic drainage in course of fortnightly ambulatory therapy at patients after mastectomy Abstract: The aim of the present work is to conduct a comparative analysis of the lymphatic drainage in course of fortnightly ambulant therapy at patients after mastectomy with regard on such features like: time after operating intervention, age, body mass index BMI, education and changing of quality of life. Material and method: The research comprised 52 women after mastectomy aged 31-81 who were treated in ambulatory clinic in Rzeszów by fortnights. Diagnostic poll method according to the effectiveness of lymphatic drainage was applied diagnostic sounding with questionnaire of quality of life – SF 36. As well as linear measurements on six levels of upper limbs was made before and after fortnightly series of interventions.Results: The results of research show the essential influence the considered factors on effectiveness of manual lymphatic drainage therapy. The largest visible differentiation in effectiveness of drainage was with regard in time from operating intervention, BMI, location the tumor (right/left limb) and physical dimension of quality of life. Conclusions: Manual lymphatic drainage course of fortnightly ambulant therapy at patients after mastectomy has significant influence on decrease of postoperative consequences and improves physical and mental health connected with quality of life.
    Chapter · Jan 2013 · Supportive Care Cancer
  • [Show abstract] [Hide abstract] ABSTRACT: In clinical practice, noticeable differences are seen in patient response to the treatment of breast cancer-related lymphedema. Although some factors influencing response to treatment are mentioned in the literature, there is no sufficient evidence and results are confusing. For this reason, our objective in this study is to identify predictive and response-related factors for response to treatment of breast cancer-related lymphedema. We analyzed data retrospectively from the files of patients with breast cancer-related lymphedema between 2006 and 2012. Patient demographics, clinical variables, and patient variables were recorded. Circumference measurements of lymphedema and healthy arms were recorded. We used a computer program (Limb Volumes Professional version 5.0) to transform these values to limb volumes in milliliters. The average age of 331 patients was 54.4 ± 10.9. The average length of lymphedema treatment was 2.92 ± 1.3 weeks. A statistically significant positive correlation was found between postoperative weight gain and postoperative duration, number of chemotherapy (CT) cycles, duration of tamoxifen use, and duration of hormonal therapy (p < 0.05). There was a statistically significant negative correlation between posttreatment arm volume and activity level, postoperative duration, and postoperative weight gain (p < 0.05). The treatment methods used for treating breast cancer had no effect on the response to treatment of lymphedema. Weight gain during the treatment of breast cancer is important for both the development of lymphedema and the response to treatment. When treating breast cancer-related lymphedema, the relationship between activity level and postoperative weight gain may provide us guidance in clinical practice.
    Article · Feb 2015
Show more