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

http://dx.doi.org/10.1590/S1677-54492010000400005 J Vasc Bras, vol.9, n4, p.233-238, 2010
PDF
SciELO
Downloads: 4
Views: 1543

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

References

The diagnosis and treatment of peripheral lymphedema: Consensus document of the International Society of Lymphology. Lymphology. 2003;36:84-91.

Soran A, D'angelo G, Begovic M. Breast cancer-related lymphedema: what are the significant predictors and how they affect the severity of lymphdema?. Breast J.. 2006;12:536-43.

Szuba A, Shin WS, Strauss W, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med.. 2003;44:43-57.

Petrek JA, Heelan MC. Incidence of breast carcinoma-related lymphedema. Cancer.. 1998;83(^s12):2776-81.

McCredie MR, Dite GS, Porter L. Prevalence of self-reported arm morbidity following treatment for breast cancer in the Australian Breast Cancer Family Study. Breast.. 2001;10:515-22.

Duff M, Hill AD, McGreal G, Walsh S, McDermott EW, O'Higgins NJ. Prospective evaluation of the morbidity of axillary clearance for breast cancer. Br J Surg.. 2001;88:114-7.

Kwan W, Jackson J, Weir LM, Dingee C, McGregor G, Olivotto IA. Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol.. 2002;20:4242-8.

Bergmann A, Mattos IE, Koifman RJ. Diagnótico do linfedema: análise dos métodos empregados na avaliação do membro superior após linfadenectomia axilar para tratamento do câncer de mama. Rev Bras Cancerol.. 2004;50:311-20.

Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: a comprehensive review. Ann Plast Surg.. 2007;59:464-72.

Rezende LF, Pedras FV, Ramos CD, Gurgel MSC. Avaliação das compensações linfáticas no pós-operatório de câncer de mama com dissecção axilar através da linfocintilografia. J Vasc Bras.. 2008;7:370-5.

Brennan MJ, DePompolo RW, Garden FH. Focused review: postmastectomy lymphedema. Arch Phys Med Rehabil.. 1996;77(^s3):S74-80.

Bernas MJ, Witte CL, Witte MH. International Society of Lymphology Executive Committee: The diagnosis and treatment of peripheral lymphedema: draft revision of the 1995 Consensus Document of the International Society of Lymphology Executive Committee for discussion at the September 3-7, 2001. 2001;34:84-91.

Camargo M, Marx A. Reabilitação física no câncer de mama. 2000.

Burt J, White G. Lymphedema: a breast cancer patient's guide to prevention and healing. 1999:2-23.

Aboul-Enein A, Eshmawy I, Arafa S, Abboud A. The role of lymphovenous communication in the development of postmastectomy lymphedema. Surgery. 1984;95:562-6.

Herd-Smith A, Russo A, Muraca MG, Del Turco MR, Cardona G. Cancer.. 2001;92:1783-7.

Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol.. 2008;26:3536-42.

Pain SJ, Vowler S, Purushotham AD. Axillary vein abnormalities contribute to development of lymphoedema after surgery for breast cancer. Br J Surgery.. 2005;92:311-15.

Johansson K, Ohlsson K, Ingvar C, Albertsson M, Ekdahl C. Factors associated with the development of arm lymphedema following breast cancer treatment: a match pair case-control study. Lymphology. ;2002(35):59-71.

Ozaslan C, Kuru B. Lymphedema after treatment of breast cancer. Am J Surg.. 2004;187:69-72.

Erickson VS, Pearson ML, Ganz PA, Adams J, Kahn KL. J Natl Cancer Inst.. 2001;93:96-111.

Purushotham AD, Bennett Britton TM, Klevesath MB, Chou P, Agbaje OF, Duffy SW. Lymph node status and breast cancer-related lymphedema. Ann Surg.. 2007;246(42-45).

Meeske KA, Sullivan-Halley J, Smith AW, McTiernan A, Baumgartner KB, Harlan LC. Risk factors for arm lymphedema following breast cancer diagnosis in Black women and White women. Breast Cancer Res Treat.. 2009;113:383-91.

Rett MT, Lopes MCA. Fatores de risco relacionados ao linfedema. Rev Bras Mastologia.. 2002;12:39-42.

Park JH, Lee WH, Chung HS. Incidence and risk factors of breast cancer lymphoedema. J Clin Nurs.. 2008;17:1450-59.

Nielsen I, Gordon S, Selby A. Breast cancer-related lymphoedema risk reduction advice: a challenge for health professionals. Cancer Treat Rev.. 2008;34:621-8.

Ellis S. Structure and function of the lymphatic system: an overview. The Lymphoedema Supplement. Br J Community Nurs.. 2006;11(^s4):S4-S6.

Petrek JA, RT Senie, Peters M, Rosen PP. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001;92:1368-77.

Pain SJ, Purushotham AD, Barber RW, Ballinger JR, Solanki CK, Mortimer PS. Variation in lymphatic function may predispose to development of breast cancer-related lymphoedema. Eur J Surg Oncol.. 2004;30:508-14.

Bergmann A, Mattos IE, Kofman RJ. Fatores de risco para linfedema após câncer de mama: uma revisão da literatura. Fisioter pesqui.. 2008;15:207-13.

Freitas Jr R, Ribeiro LFJ, Taia L, Kajita D, Fernandes MV, Queiroz GS. Linfedema em pacientes submetidos à mastectomia radical modificada. Rev Bras Ginecol Obstet.. 2001;23:205-8.

Guedes Neto HJ, Kupsinskas Junior AJ, Stuart S, Barbosa EM, Bacarat FF. Cir Vasc Angiol.. ;1995:107-10.

Campisi C, Michelini S, Boccardo F. Guidelines of the Societá Italiana di Linfangiologia. Lymphology. 2004;37:182-4.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddebe590e8825b50d7279a1 jvb Articles
Links & Downloads
1677-7301 (Electronic)
J Vasc Bras ©2024 All rights reserved.

J Vasc Bras

Share this page
Page Sections