본문 바로가기
KERD
논문KCI 등재

Quantitative Lymphoscintigraphy to Predict the Possibility of Lymphedema Development After Breast Cancer Surgery: Retrospective Clinical Study

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류재활의학

초록

Objective To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment.Methods This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups.Results Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04–0.46; p=0.001).Conclusion In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.

Abstract

Objective To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment.Methods This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups.Results Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04–0.46; p=0.001).Conclusion In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.

참고문헌 (39)

  1. Warren AG, "Lymphedema:a comprehensive review", Ann Plast Surg, 59, pp.464~472 (2007)
  2. McLaughlin SA, "Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements", J Clin Oncol, 26, pp.5213~5219 (2008)
  3. Dominick SA, "Risk factors associated with breast cancer-related lymphedema in the WHEL Study", J Cancer Surviv, 7, pp.115~123 (2013)
  4. Rezende LF, "Risk factors for breast cancer related lymphedema", J Vasc Bras, 9, pp.233~238 (2010)
  5. Sarri AJ, "Physiotherapeutic stimulation: Early prevention of lymphedema following axillary lymph node dissection for breast cancer treatment", Exp Ther Med, 1, pp.147~152 (2010)
  6. Dalia RM, "Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema", Braz Arch Biol Technol, 48, pp.159~162 (2005)
  7. Linnitt N, "Lymphoedema: recognition, assessment and management", Br J Community Nurs, 10, pp.S20~26 (2005)
  8. Deltombe T, "Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema", Lymphology, 40, pp.26~34 (2007)
  9. Soo JK, "Lymphatic abnormalities demonstrated by lymphoscintigraphy after lower limb cellulitis", Br J Dermatol, 158, pp.1350~1353 (2008)
  10. Bernas MJ, "Lymphedema:how do we diagnose and reduce the risk of this dreaded complication of breast cancer treatment?", Curr Breast Cancer Rep, 2, pp.53~58 (2010)
  11. Kwan ML, "Risk factors for lymphedema in a prospective breast cancer survivorship study: the pathways study", Arch Surg, 145, pp.1055~1063 (2010)
  12. Ahmed RL, "Risk factors for lymphedema in breast cancer survivors, the Iowa Women’s Health Study", Breast Cancer Res Treat, 130, pp.981~991 (2011)
  13. Norman SA, "Risk factors for lymphedema after breast cancer treatment", Cancer Epidemiol Biomarkers Prev, 19, pp.2734~2746 (2010)
  14. Szuba A, "The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema", J Nucl Med, 44, pp.43~57 (2003)
  15. Yuan Z, "The role of radionuclide lymphoscintigraphy in extremity lymphedema", Ann Nucl Med, 20, pp.341~344 (2006)
  16. Sadeghi R, "Diagnostic application of lymphoscintigraphy in the management of lymphoedema", Hell J Nucl Med, 13, pp.6~10 (2010)
  17. International Society of Lymphology, "The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology", Lymphology, 46, pp.1~11 (2013)
  18. Szuba A, "Lymphedema: classification, diagnosis and therapy", Vasc Med, 3, pp.145~156 (1998)
  19. Ter SE, "Lymphoscintigraphy:a reliable test for the diagnosis of lymphedema", Clin Nucl Med, 18, pp.646~654 (1993)
  20. Weissleder H, "Lymphedema: evaluation of qualitative and quantitative lymphoscintigraphy in 238 patients", Radiology, 167, pp.729~735 (1988)
  21. Starritt EC, "Lymphedema after complete axillary node dissection for melanoma: assessment using a new, objective definition", Ann Surg, 240, pp.866~874 (2004)
  22. Hayes SC, "Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function", J Clin Oncol, 26, pp.3536~3542 (2008)
  23. DiSipio T, "Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis", Lancet Oncol, 14, pp.500~515 (2013)
  24. Tsai RJ, "The risk of developing arm lymphedema among breast cancer survivors: a metaanalysis of treatment factors", Ann Surg Oncol, 16, pp.1959~1972 (2009)
  25. Chandra RA, "Radiation therapy risk factors for development of lymphedema in patients treated with regional lymph node irradiation for breast cancer", Int J Radiat Oncol Biol Phys, 91, pp.760~764 (2015)
  26. McLaughlin SA, "Lymphedema: separating fact from fiction", Oncology (Williston Park), 26, pp.242~249 (2012)
  27. Herd-Smith A, "Prognostic factors for lymphedema after primary treatment of breast carcinoma", Cancer, 92, pp.1783~1787 (2001)
  28. Kiel KD, "Early-stage breast cancer:arm edema after wide excision and breast irradiation", Radiology, 198, pp.279~283 (1996)
  29. Paskett ED, "The epidemiology of arm and hand swelling in premenopausal breast cancer survivors", Cancer Epidemiol Biomarkers Prev, 16, pp.775~782 (2007)
  30. Ozaslan C, "Lymphedema after treatment of breast cancer", Am J Surg, 187, pp.69~72 (2004)
  31. Hinrichs CS, "Lymphedema secondary to postmastectomy radiation: incidence and risk factors", Ann Surg Oncol, 11, pp.573~580 (2004)
  32. Shih YC, "Incidence, treatment costs, and complications of lymphedema after breast cancer among women of working age: a 2-year follow-up study", J Clin Oncol, 27, pp.2007~2014 (2009)
  33. Yen TW, "A contemporary, population-based study of lymphedema risk factors in older women with breast cancer", Ann Surg Oncol, 16, pp.979~988 (2009)
  34. Meeske KA, "Risk factors for arm lymphedema following breast cancer diagnosis in Black women and White women", Breast Cancer Res Treat, 113, pp.383~391 (2009)
  35. Wang L, "A scoring system to predict arm lymphedema risk for individual Chinese breast cancer patients", Breast Care (Basel), 11, pp.52~56 (2016)
  36. Carena M, "Quantitative lymphoscintigraphy", Eur J Nucl Med, 14, pp.88~92 (1988)
  37. Toyserkani NM, "Tc-99mhuman serum albumin transit time as a measure of arm breast cancer-related lymphedema", Plast Reconstr Surg Glob Open, 5, pp.e1362~ (2017)
  38. Simonsen J, "Quantification of breast cancer-related lymphedema of the upper limbs", J Nucl Med, 58(Suppl 1), pp.468~ (2017)
  39. Witte CL, "Advances in imaging of lymph flow disorders", Radiographics, 20, pp.1697~1719 (2000)

관련 논문AI추천

Validity of Quantitative Lymphoscintigraphy as a Lymphedema Assessment Tool for Patients With Breast Cancer민유선, 박호영, 유지나, 이상우, 정윤수, 정태두대한재활의학회 · Annals of Rehabilitation Medicine2015 · 제39권 제6호Early Stage Lymphedema in Breast Cancer Patient Detected by Indocyanine Green Lymphography but not by Lymphoscintigraphy: A Case Report박희성, Jin A Yoon, Joo Hyoung Kim, Myung Jun Shin, Taewoo Kang, Young Jin Choi한국유방암학회 · Journal of Breast Disease2019 · 제7권 제2호Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer강한성, 김명수, 김연주, 김태현, 신경환, 이시연, 이은숙, 정소연, 정승현, 조관호대한암학회 · Cancer Research and Treatment2016 · 제48권 제4호Long-Term Effects of Complex Decongestive Therapy in Breast Cancer Patients With Arm Lymphedema After Axillary Dissection황정민, 황지혜대한재활의학회 · Annals of Rehabilitation Medicine2013 · 제37권 제5호Breast Cancer–Related Lymphedema after Neoadjuvant Chemotherapy강한성, 김명수, 김태현, 노정실, 박인해, 신경환, 이근석, 이시연, 이은숙, 정소연, 조관호대한암학회 · Cancer Research and Treatment2015 · 제47권 제3호Quality of Life, Upper Extremity Function and the Eff ect of Lymphedema Treatment in Breast Cancer Related Lymphedema Patients서관식, Hye Jin Jang, Ji Eung Park대한재활의학회 · Annals of Rehabilitation Medicine2012 · 제36권 제2호

이 간행물의 다른 논문 (23건)