Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492010000400005
Jornal Vascular Brasileiro
Review Article

Avaliação dos fatores de risco no linfedema pós-tratamento de câncer de mama

Risk factors for breast cancer related lymphedema

Laura Ferreira de Rezende; Alessandra Vilanova Reis Rocha; Caroline Silvestre Gomes

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Resumo

A principal complicação tardia no pós-operatório de câncer de mama é o desenvolvimento do linfedema, uma doença crônica, progressiva, geralmente incurável. O aumento do volume do membro pode desfigurar a imagem corporal, assim como aumentar a morbidade física e psicológica da paciente, além de promover significativo prejuízo para as funções. O presente estudo foi desenvolvido por meio de uma revisão sistemática a partir do cruzamento aleatório das palavras-chave: "linfedema", "compensações linfáticas", "sistema linfático", "dissecção axilar", "fatores de risco" e "câncer de mama". Foram selecionados 18 artigos entre os anos de 1979 e 2009, nos quais foram encontrados como principais fatores de risco para o desenvolvimento do linfedema a radioterapia, radioterapia axilar, infecção, dissecção axilar seguida de radioterapia, obesidade, número de linfonodos retirados e comprometidos e agressividade da cirurgia. As formas de compensação linfática após a dissecção axilar, como as anastomoses linfo-linfáticas, podem ser prejudicadas pela formação cicatricial, seroma pós-operatório, radioterapia e exercícios inadequados para reabilitação de ombro no câncer de mama.

Palavras-chave

Linfedema, sistema linfático, excisão de linfonodo, fatores de risco, neoplasias da mama

Abstract

The main late complication after the surgery of breast cancer is the development of lymphedema, a chronic, progressive, usually incurable disease. The increase in the volume of the limb can disfigure the body image and develop the physical and psychological morbidity of the patient, promoting significant damage to the functions. This study was developed through a systematic review from the randomized crosschecking of the keywords "lymphedema", "lymphatic compensation", "lymphatic system", "axillary dissection", "risk factors" and "breast cancer". Eighteen articles were selected, between 1979 and 2009, in which radiotherapy, axillary radiation, infection, axillary dissection followed by radiotherapy, obesity, number of removed and impaired lymph nodes and aggressiveness of surgery were found as main risk factors for the development of lymphedema. The way of compensation after the lymphatic axillary dissection, as the lympho-lymphatic anastomoses, may be hindered by scar formation, seroma after surgery, radiotherapy and inappropriate exercises for the shoulder rehabilitation in breast cancer.

Keywords

Lymphedema, lymphatic system, lymph node excision, risk factors, breast neoplasms

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