Systematic review of breast cancer related lymphoedema: making a balanced decision to perform an axillary clearance.

Autor:	Göker M; Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg Campus St Jan, Schiepse Bos 6, 3600 Genk, -Belgium., Devoogdt N; Department of Revalidation Sciences, University Hospitals Leuven, Herestraat 49 bus 7003, 3000 Leuven, Belgium., Van de Putte G; Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg Campus St Jan, Schiepse Bos 6, 3600 Genk, -Belgium., Schobbens JC; Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg Campus St Jan, Schiepse Bos 6, 3600 Genk, -Belgium., Vlasselaer J; Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg Campus St Jan, Schiepse Bos 6, 3600 Genk, -Belgium., Van den Broecke R; Department of Obstetrics & Gynaecology, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium., de Jonge ET; Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg Campus St Jan, Schiepse Bos 6, 3600 Genk, -Belgium.
Jazyk:	angličtina
Zdroj:	Facts, views & vision in ObGyn [Facts Views Vis Obgyn] 2013; Vol. 5 (2), pp. 106-15.
Abstrakt:	Aim: Breast cancer-related lymphoedema (BCRL) is a disabling complication developing after breast cancer treatment in a proportion of patients. Its impact on quality of life becomes more substantial as survival after breast cancer diagnosis increases. The incidence of BCRL following breast cancer treatment varies due to a lack of -uniform definition and measurement criteria. This review aims to determine the prevalence of BCRL following axillary lymph node dissection (ALND) as a benchmark to be used in a risk-benefit medical decision whether to proceed with ALND or not. The risk of leaving unresected non-sentinel metastatic lymph nodes with a presumed inherent risk of local recurrence will be balanced against the risk of BCRL following a potentially unnecessary ALND. Methods: Pubmed and Embase databases were searched for all publications on BCRL in order to estimate its -incidence and to decide on the most appropriate measurement method to use in clinical practice. Results: 51 articles were identified on BCRL incidence and measurement technique. Most studies measured BCRL based on differences in arm circumference (n = 18) or by self-reported symptoms (n = 18). The weighted average of BCRL incidence following ALND measured by self-report and circumference method was 28% and 16%, respectively. Conclusion: The importance of ALND and irradiation as part of the treatment of operable breast carcinoma is well established, but its morbidity is less well documented. We argue self-report as the most appropriate method to -establish a diagnosis of BCRL. Therefore a 28% risk of finding non-sentinel lymph node metastases in a completion ALND will be regarded as the cut-off in a medical decision to proceed with ALND.
Databáze:	MEDLINE
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