Ultrasound elastography as an objective diagnostic measurement tool for lymphoedema of the treated breast in breast cancer patients following breast conserving surgery and radiotherapy.

Ultrasound elastography as an objective diagnostic measurement tool for lymphoedema of the treated breast in breast cancer patients following breast conserving surgery and radiotherapy.

2012

Adriaenssens N, Belsack D, Buyl R, Ruggiero L, Breucq C, De Mey J, Lievens P, Lamote J.

Source

Physical Therapy Department, Universitair Ziekenhuis Brussel, Belgium ; Physical Therapy Department, Vrije Universiteit Brussel, Belgium.

Abstract

BACKGROUND:

Lymphoedema of the operated and irradiated breast is a common complication following early breast cancer treatment. There is no consensus on objective diagnostic criteria and standard measurement tools. This study investigates the use of ultrasound elastography as an objective quantitative measurement tool for the diagnosis of parenchymal breast oedema. 

PATIENTS AND METHODS: 

The elasticity ratio of the subcutis, measured with ultrasound elastography, was compared with high-frequency ultrasound parameters and subjective symptoms in twenty patients, bilaterally, prior to and following breast conserving surgery and breast irradiation. 

RESULTS: 

Elasticity ratio of the subcutis of the operated breast following radiation therapy increased in 88.9% of patients, was significantly higher than prior to surgery, unlike the non operated breast and significantly higher than the non operated breast, unlike preoperative results. These results were significantly correlated with visibility of the echogenic line, measured with high-frequency ultrasound. Big preoperative bra cup size was a significant risk factor for the development of breast oedema. 

CONCLUSIONS: 

Ultrasound elastography is an objective quantitative measurement tool for the diagnosis of parenchymal breast oedema, in combination with other objective diagnostic criteria. Further research with longer follow-up and more patients is necessary to confirm our findings.

PubMed

Omental flap for treatment of long standing lymphoedema of the lower limb: can it end the suffering? Report of four cases with review of literatures.

Feb 2013

Attash SM, Al-Sheikh MY.

Source

Department of Surgery, Ninava Medical College, Mosul University, Mosul, Iraq.

Abstract

We report our experience of four cases of long-standing unilateral, secondary lymphoedema of the lower limb, for which conservative treatment has failed, that were treated in our centre using pedicled omental flap. The four patients were followed for a period of 1 year after the procedures and frequent measurements of the circumference of the affected limb revealed a reduction in the circumference ranging between 50% in the first patient to 75% in the fourth patient together with an excellent functional improvement in terms of resuming walking, daily activities, sports and work. We think that pedicled omental flap is an important, relatively easy and safe option that deserves consideration in refractory cases of lymphoedema of the lower limb.

BMJ Case Reports

Complete decongestive therapy for treatment of lymphedema.

Feb 2013

Lasinski BB.

Abstract

OBJECTIVES:

To summarize current evidence on the management of lymphedema and to provide management recommendations.

DATA SOURCES:

Eleven databases, including PubMed and CINAHL from 2004-2011.

CONCLUSION:

Complete decongestive therapy (CDT) is effective in reducing lymphedema, although the contribution of each individual complete decongestive therapy component has not been determined. In general, levels of evidence for complete decongestive therapy are mid-level.

IMPLICATIONS FOR NURSING PRACTICE:

Oncology nurses and health care providers play key roles in assessing needs and prescribing interventions to support patients with lymphedema from admission to discharge. Reviewing risk-reduction strategies and supporting the patient with lymphedema to continue self-care when undergoing medical treatment empowers patients to be proactive in health maintenance. Identifying potential problems and making appropriate referral to a lymphedema specialist avoids triggering or worsening lymphedema.

Elsevier - Oncology Nursing