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

Göker M, Devoogdt N, Van de Putte G, Schobbens JC, Vlasselaer J, Van den Broecke R, de Jonge ET - Facts Views Vis Obgyn (2013)

Bottom Line: 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. 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).We argue self-report as the most appropriate method to -establish a diagnosis of BCRL.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg Campus St Jan, Schiepse Bos 6, 3600 Genk, -Belgium.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Incidence of BCRL assessed by arm circumference measurements and by self-report for the different studies with more than 12 months of follow-up and the weighted mean incidence.
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Figure 2: Incidence of BCRL assessed by arm circumference measurements and by self-report for the different studies with more than 12 months of follow-up and the weighted mean incidence.

Mentions: The overall weighted average incidence of BCRL was 16% (5% up to 33%) for the arm circumference method and 28% (11% up to 39%) for the self-report method (Table I, Fig. 2). Tables II and III summarize a total of 36 reports on BCRL incidence based on arm circumference and self-report respectively, following treatment for breast cancer including ALND. The studies are a mixture of retro- and prospective studies. Most studies were published after the year 2000 and included almost nineteen thousand patients.


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

Göker M, Devoogdt N, Van de Putte G, Schobbens JC, Vlasselaer J, Van den Broecke R, de Jonge ET - Facts Views Vis Obgyn (2013)

Incidence of BCRL assessed by arm circumference measurements and by self-report for the different studies with more than 12 months of follow-up and the weighted mean incidence.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3987359&req=5

Figure 2: Incidence of BCRL assessed by arm circumference measurements and by self-report for the different studies with more than 12 months of follow-up and the weighted mean incidence.
Mentions: The overall weighted average incidence of BCRL was 16% (5% up to 33%) for the arm circumference method and 28% (11% up to 39%) for the self-report method (Table I, Fig. 2). Tables II and III summarize a total of 36 reports on BCRL incidence based on arm circumference and self-report respectively, following treatment for breast cancer including ALND. The studies are a mixture of retro- and prospective studies. Most studies were published after the year 2000 and included almost nineteen thousand patients.

Bottom Line: 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. 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).We argue self-report as the most appropriate method to -establish a diagnosis of BCRL.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg Campus St Jan, Schiepse Bos 6, 3600 Genk, -Belgium.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus