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Oncology (Williston Park, N.Y.) Mar 2012Lymphedema is a feared complication of cancer treatment and one that negatively impacts survivorship. The incidence of breast cancer-related lymphedema ranges from 6% to... (Review)
Review
Lymphedema is a feared complication of cancer treatment and one that negatively impacts survivorship. The incidence of breast cancer-related lymphedema ranges from 6% to 70%, but lymphedema may be a common and under-reported morbidity. No standard guidelines for its diagnosis and assessment exist. Although the true etiology of lymphedema remains unknown, radiation, chemotherapy, type of breast surgery, and extent of axillary surgery are commonly cited risk factors. However, the relationship between the number of nodes removed and the risk of lymphedema is not clearly correlated. Clinical trials are focusing on ways to reduce the need for axillary dissection even in the setting of a positive sentinel node, to help minimize axillary morbidity. Risk-reduction practices, including avoidance of skin puncture and blood pressures in the ipsilateral upper extremity, and precautionary behaviors such as wearing compression garments during air travel continue to be advocated by the medical and survivor communities, despite a lack of rigorous evidence supporting their benefit. Emerging data support exercise in at-risk and affected women with lymphedema when started gradually and increased cautiously.
Topics: Breast Neoplasms; Female; Humans; Lymphedema
PubMed: 22545305
DOI: No ID Found -
Medical Principles and Practice :... 2013To report a rare case of familial lymphedema (Milroy disease) affecting 4 generations of individuals.
OBJECTIVE
To report a rare case of familial lymphedema (Milroy disease) affecting 4 generations of individuals.
CLINICAL PRESENTATION AND INTERVENTION
A 28-year-old woman presented with bilateral pedal edema which she had since birth. A detailed evaluation including blood counts, metabolic panel and imaging studies ruled out secondary causes of lymphedema. The family history revealed many affected individuals up to 4 generations. She was reassured about the potential benign yet familial nature of this condition. She was advised to wear compression stockings and to avoid scratches or skin breakdowns in the lower extremities to prevent cellulitis.
CONCLUSION
This case showed the occurrence of asymptomatic progressive lymphedema in 4 generations of individuals.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Lymphedema; Male; Pedigree; Young Adult
PubMed: 23751338
DOI: 10.1159/000351571 -
Deutsche Medizinische Wochenschrift... Dec 2017
Topics: Humans; Lymphedema
PubMed: 29207421
DOI: 10.1055/s-0043-108273 -
Minnesota Medicine Sep 1974
Topics: Adult; Cerebrovascular Disorders; Humans; Lymphedema; Male; Thrombocytosis
PubMed: 4853224
DOI: No ID Found -
Professional Nurse (London, England) Oct 2001
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Surgery, Gynecology & Obstetrics Oct 1972
Review
Topics: Animals; Humans; Lymphatic System; Lymphedema; Skin Transplantation; Transplantation, Autologous; Veins
PubMed: 4562125
DOI: No ID Found -
BMJ (Clinical Research Ed.) Jun 2000
Review
Topics: Humans; Leg; Lymphedema; Vascular Diseases
PubMed: 10834903
DOI: 10.1136/bmj.320.7248.1527 -
The American Journal of Nursing Jul 2009Lymphedema, which can be a debilitating sequela to breast cancer treatment, is characterized by an abnormal accumulation of lymph in the arm, shoulder, breast, or... (Review)
Review
Lymphedema, which can be a debilitating sequela to breast cancer treatment, is characterized by an abnormal accumulation of lymph in the arm, shoulder, breast, or thoracic area. It may appear gradually or suddenly, and although it usually develops within three years of a breast cancer diagnosis, it can arise much later; survivors remain at lifetime risk. The condition can cause physical discomfort and pain, impaired function, and emotional distress. It's imperative that survivors' risk of lymphedema be reduced and that those who develop it receive help to manage it. Part 1 of this two-part article describes post-breast cancer lymphedema and discusses its diagnosis and measurement. Part 2 (next month) will discuss risk reduction, treatment, and implications for nurses.
Topics: Breast Neoplasms; Disease Progression; Female; Humans; Lymphedema
PubMed: 19546644
DOI: 10.1097/01.NAJ.0000357172.94131.58 -
International Journal of... Feb 1993Microlymphatics of human skin form two superposed networks. The superficial one located at the level of dermal papillae may be visualized by fluorescence... (Review)
Review
Microlymphatics of human skin form two superposed networks. The superficial one located at the level of dermal papillae may be visualized by fluorescence microlymphography. Microlymphatics fill from a subepidermal depot of minute amounts of FITC-dextran 150,000. In primary lymphedema with late onset the depicted network with vessels of normal size is significantly larger than in healthy controls, whereas in congenital lymphedema (Milroy's disease) microlymphatics are aplastic or ectatic (diameter > 90 microns). Lymphatic microangiopathy with obliterations of microvessels develops in chronic venous insufficiency, in lipedema (preliminary results) and after recurrent erysipelata. In healthy controls microlymphatics are permeable to FITC-dextran 40,000 and impermeable to the larger molecule 150,000. Preserved fragments of the network in chronic venous insufficiency exhibit increased permeability to FITC-dextran 150,000. After visualization of the vessels by the fluorescent dye microlymphatic pressure may be measured by the servo-nulling technique. First results indicate that microlymphatic hypertension contributes to edema formation in patients with primary lymphedema.
Topics: Edema; Fingers; Humans; Lymphatic Diseases; Lymphatic System; Lymphedema; Microscopy, Fluorescence; Replantation; Skin
PubMed: 8473066
DOI: No ID Found -
Vascular Medicine (London, England) 1998This review presents the diagnostic features, the pathophysiology and the available therapies for lymphedema. This disease is often able to be diagnosed by its... (Review)
Review
This review presents the diagnostic features, the pathophysiology and the available therapies for lymphedema. This disease is often able to be diagnosed by its characteristic clinical presentation, yet, in some cases, ancillary tests might be necessary to establish the diagnosis, particularly in the early stages of the disease and in edemas of mixed etiology. These diagnostic modalities are also useful in clinical studies. Available modalities include isotopic lymphoscintigraphy, indirect and direct lymphography, magnetic resonance imaging, computed tomography and ultrasonography. Lymphedema may be primary or secondary to the presence of other disease and/or to the consequences of surgery. Primary lymphedema may occur at any phase of life but it most commonly appears at puberty. Secondary lymphedema is encountered more often. The most prevalent worldwide cause of lymphedema is filariasis, which is particularly common in south-east Asia. In the USA, postsurgical lymphedema of the extremity prevails. Complications of chronic limb lymphedema include recurrent cellulitis and lymphangiosarcoma. Most patients are treated conservatively, by means of various forms of compression therapy, including complex physical therapy, pneumatic pumps and compressive garments. Volume reducing surgery is performed rarely. Lymphatic microsurgery is still in an experimental stage, although a few centers consistently report favorable outcomes.
Topics: Combined Modality Therapy; Humans; Lymphedema; Magnetic Resonance Imaging; Microsurgery; Radionuclide Imaging; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography
PubMed: 9796078
DOI: 10.1177/1358836X9800300209