The Findings of SPECT/CT Concerning Bypass Lymph Circulation in Lymphedema Following Breast Cancer Surgery

This study aimed to determine whether bypass circulation was present in lymphedema and its effect. This was a retrospective, cross-sectional study. Patients who underwent unilateral breast cancer surgery with axillary lymph node dissection were recruited and underwent single-photon emission tomography/computed tomography (SPECT/CT). SPECT/CT was performed to detect the three-dimensional locations of radio-activated lymph nodes. Patients with radioactivity in anatomical locations other than axillary lymph nodes were classified into a positive group. All patients received complete decongestive therapy (CDT). Exclusion criteria were as follows: History of bilateral breast cancer surgery, cervical lymph node dissection history, and upper extremity amputation. The difference in the upper extremity circumference (cm) was measured at four points: Mid-point of the upper arm, elbow, and 10 and 15 cm below the elbow. Twenty-nine patients were included in this study. Fifteen patients (51.7%) had bypass lymphatic systems on the affected side, six (20.7%) had a bypass lymphatic system with axillary lymph nodes on the unaffected side, and 11 (37.9%) showed new lymphatic drainage. The positive group showed significantly less swelling than the negative group at the mid-arm, elbow, and 15 cm below the elbow. Bypass lymphatic circulation had two patterns: Infraclavicular lymph nodes and supraclavicular and/or cervical lymph nodes. Changes in lymph drainage caused by surgery triggered the activation of the superficial lymphatic drainage system to relieve lymphedema. Superficial lymphatic drainage has a connection through the deltopectoral groove.

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Sentinel lymph node biopsy in breast cancer surgery

Reviews in Health Care ◽

10.7175/rhc.v2i2.26 ◽

2011 ◽

Vol 2 (2) ◽

pp. 101-112

Author(s):

Mario Taffurelli

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Lymphatic System ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Axillary Lymph Nodes ◽

Axillary Lymph

Axillary lymph node status is one of the most reliable prognostic factors of long-term survival in breast cancer surgery. Metastatic involvement of the axillary lymph nodes is also crucial in the decision making of potentially useful adjuvant treatment. Until the last decade, Axillary Lymph Nodes Dissection (ALND) was performed in order to obtain the regional lymphatic system staging. In case of non-metastatic spread, that kind of surgery was limited only to this purpose; no further oncological benefits were obtained and the patients were exposed to several comorbidities affecting this type of surgery. Complications after ALND are reported in 15-30% of cases. They are well known and range from early bleeding, infection, symptomatic nerve damage, and longstanding limb lymph-edema with an incredible impairment of the quality of life.The Sentinel Lymph Node (SLN) theory holds that the SLNs are the first nodes draining lymph from an anatomic region (i.e. the breast) where metastatic disease will most likely to be found. If that node is found to be cancer free, the entire lymphatic system is likely to be cancer free; if it is metastatic, there is an elevated chance of finding more metastatic nodes. Thanks to the application of this hypothesis, several patients over the last 10-15 years have avoided unnecessary major demolitive surgery. To obtain accurate evaluation of the SLN a multidisciplinary dedicated team is necessary. This procedure has been internationally validated and the false negative rate is nowadays less than 5% when performed by expert hands. Dedicated breast surgeons working in a high-volume centres are necessary to reach satisfactory confidence in performing this very specialised procedure in order to obtain an accurate staging. The number of women presenting to the breast oncology units is continuously increasing and the implementation of screening programs has been crucial in detecting numerous patients (more than 75%) with early disease and non-metastatic axillary lymph nodes. The practice of the SLN is clearly able to offer those patients an accurate staging with low comorbidities, preserving their quality of life.

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Effect of Axillary Lymph Node Dissection on Prevalence and Intensity of Chronic and Phantom Pain After Breast Cancer Surgery

Journal of Pain ◽

10.1016/j.jpain.2008.04.001 ◽

2008 ◽

Vol 9 (9) ◽

pp. 813-822 ◽

Cited By ~ 62

Author(s):

Monique A. Steegers ◽

Bas Wolters ◽

Andrea W. Evers ◽

Luc Strobbe ◽

Oliver H. Wilder-Smith

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Phantom Pain ◽

Axillary Lymph ◽

Node Dissection

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Ultrasound Imaging for Detecting Metastasis to Level II and III Axillary Lymph Nodes after Axillary Lymph Node Dissection for Invasive Breast Cancer

Journal of Ultrasound in Medicine ◽

10.1002/jum.14998 ◽

2019 ◽

Vol 38 (11) ◽

pp. 2925-2934

Author(s):

Xi Lin ◽

Xin An ◽

Huiling Xiang ◽

Xiaoqing Pei ◽

Anhua Li ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Ultrasound Imaging ◽

Invasive Breast Cancer ◽

Axillary Lymph Node ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Node Dissection ◽

Level Ii

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The Need for Axillary Lymph Node Dissection in T1/T2 Breast Cancer Surgery—Reply to Counterpoint

Cancer Research ◽

10.1158/0008-5472.can-13-2413 ◽

2013 ◽

Vol 73 (24) ◽

pp. 7161-7161

Author(s):

Monica Morrow

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Axillary Lymph ◽

Node Dissection

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17-Year Follow-Up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial

10.21203/rs.3.rs-827781/v1 ◽

2021 ◽

Author(s):

Chengyu Luo， ◽

Guang Cao ◽

Wenbin Guo ◽

Jie Yang ◽

Qiuru Sun ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Axillary Lymph ◽

Node Dissection

Abstract Background: Longer follow-up was necessary to testify the exact value of mastoscopic axillary lymph node dissection (MALND).Methods：From January 1, 2003 to December 31, 2005, 1027 patients with breast cancer were randomly assigned to two groups: MALND and CALND (conventional axillary lymph node dissection). 996 eligible patients were enrolled.Results：The final cohort of 996 patients was followed for an average of 198 months. The events other than death differed significantly between the two cohorts（p=0.0311） (46.3% in MALND and 53.2% in CALND, respectively). The sum of the events other than death and deaths from other causes was much more in CALND （59.6%）than in MALND (53.4%）（p=0.0494）. The 17-year DFS rates were 36.7 percent for MALND group and 33.6 percent for CALND group，respectively. There was a signiﬁcant difference between the groups (p=.0306). The OS rates were 53.2 percent after MALND and 46.0 percent after CALND ( p= .0119). The MALND patients had much less axillary pain (p =. 0000), numbness or paresthesia (p = .0000) ，arm mobility (p =. 0000), and arm swelling on operated side (p = .0000). The aesthetic appearance of axilla in MALND group was much better than that in CALND group (p =. 0000) at an average follow-up of 17-year.Conclusions：The use of MALND in breast cancer surgery not only decreases the relapse and arm complications but also improves long-term survival of patients. Therefore, MALND should be one of the preferred approaches for breast cancer surgery when ALND is needed.

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