PDF(Pubmed)
Abstract：
While upper limb lymphoedema following breast and axillary surgery is well established in the literature, breast lymphoedema is rarely documented. Our primary objective was to identify risk factors of breast lymphoedema, and our secondary aim was to assess the possibility of using a breast ultrasound scan to assess breast lymphoedema. This study was a case series analysis, including patients who had wide local excision for primary breast cancer treatment between January 2013 and January 2018. Patients\' demographics, including age, weight, body mass index (BMI), breast volume, tumour characteristics, and histological findings, were noted. All patients had a clinical assessment and ultrasound scan 6 months and 12 months after surgery, comparing ipsilateral to the contralateral breast skin, subcutaneous thickness, as well as parenchymal changes. We have included two hundred eighty-six breast cancer; the mean age was 54.7 years SD 17.3, the mean weight was 76.5 kg SD 12.6, the mean BMI was 31.5 SD 5.2, and the mean breast volume was 1223 ml SD 179. This study identified breast lymphoedema in patients with clinically detected skin oedema in the absence of radiotherapy skin changes; skin and subcutaneous 5 mm added thickness more than the contralateral side, and based on that, 22 patients (7.7%) were found to have breast lymphoedema. We have also found that patients with high BMI, larger breast volume, upper outer quadrant tumours, and patients who had axillary lymph node clearance had an increased incidence of breast lymphoedema. The incidence of breast lymphoedema in this cohort was 7.7%. We suggest that breast lymphoedema should be considered if skin and subcutaneous thickness are 5 mm more than the contralateral side in the absence of severe radiotherapy skin changes. Also, we have found that high body mass index (BMI), larger breast volume, upper outer quadrant tumours, and patients who had axillary lymph node clearance are associated with an increased incidence of breast lymphoedema.
摘要：
虽然乳腺和腋窝手术后的上肢淋巴水肿在文献中已得到证实，乳腺淋巴水肿很少被记录。我们的主要目标是确定乳腺淋巴水肿的危险因素，我们的次要目的是评估使用乳腺超声扫描评估乳腺淋巴水肿的可能性.这项研究是一个案例系列分析，包括2013年1月至2018年1月期间接受局部广泛切除原发性乳腺癌治疗的患者.患者人口统计学，包括年龄,体重,体重指数（BMI），乳房体积,肿瘤特征，和组织学发现，被注意到。所有患者在手术后6个月和12个月进行临床评估和超声扫描，比较同侧和对侧乳房皮肤，皮下厚度,以及实质的变化。我们纳入了二百八十六例乳腺癌；平均年龄为54.7岁SD17.3，平均体重为76.5kgSD12.6，平均BMI为31.5SD5.2，平均乳房体积为1223mlSD179。这项研究发现，在没有放疗的情况下，临床检测到皮肤水肿的患者的乳腺淋巴水肿;皮肤和皮下增加了5毫米的厚度，基于此,发现22例（7.7％）患有乳腺淋巴水肿。我们还发现高BMI的患者，乳房体积较大,上外象限肿瘤，腋窝淋巴结清除的患者乳腺淋巴水肿的发生率增加。该队列中乳腺淋巴水肿的发生率为7.7％。我们建议，在没有严重放疗皮肤变化的情况下，如果皮肤和皮下厚度比对侧大5毫米，则应考虑乳房淋巴水肿。此外，我们发现高体重指数(BMI)，乳房体积较大,上外象限肿瘤，腋窝淋巴结清除的患者与乳腺淋巴水肿的发生率增加有关。
