The Risk of Lymphedema After Breast Cancer Surgery Should Not Restrict Necessary Hand Surgery Interventions.

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2024-09-01 Epub Date: 2023-02-21 DOI:10.1177/15589447231155583
Michael J Fitzgerald, Jesse Galina, Emily Kolodka, Ariel Henig, Sayyida Hasan, Susan Maltser, Lewis B Lane, Kate W Nellans
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Abstract

Background: The purpose of this study was to evaluate the incidence of lymphedema onset or exacerbation in patients undergoing upper extremity interventions, both nonoperative and operative, after breast cancer surgery.

Methods: The study inclusion criteria were the following: (1) prior history of breast cancer surgery or lymphedema from the cancer; (2) upper extremity intervention, ipsilateral to the breast cancer side; and (3) follow-up of at least 1 month. Patients were evaluated for demographic information, type of breast cancer procedure and hand intervention, number of lymph nodes dissected, preexisting lymphedema, exacerbation of lymphedema, and new-onset lymphedema.

Results: A total of 161 patients undergoing 385 hand interventions (300 injections, 85 surgeries) were reviewed. Median follow-up was 31 months (range: 1-110). Nineteen patients had preexisting lymphedema ipsilateral to the hand procedure and none experienced an exacerbation of their lymphedema. Three patients developed new-onset lymphedema ipsilateral to their hand intervention at an average follow-up of 30 months (range: 4-67). One patient had a single injection and developed lymphedema over 5 years later. One had 2 injections in the same hand on the same date and developed lymphedema 3 months later. The third patient had 2 injections in the right hand, 1 injection and 1 surgery in the left hand, and developed either lymphedema or swelling due to rheumatoid arthritis in the right hand 1 year after the injections.

Conclusions: Patients who have undergone breast cancer surgery can safely undergo upper extremity intervention with low risk of lymphedema exacerbation or onset.

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乳腺癌手术后出现淋巴水肿的风险不应限制必要的手部手术干预。
背景:本研究旨在评估乳腺癌手术后接受上肢介入治疗(包括非手术治疗和手术治疗)的患者淋巴水肿发生或加重的情况:本研究旨在评估乳腺癌术后接受上肢介入治疗(包括非手术和手术)的患者淋巴水肿发生或加重的发生率:研究纳入标准如下:(1)既往有乳腺癌手术史或因癌症引起的淋巴水肿;(2)上肢介入治疗,同侧为乳腺癌一侧;(3)随访至少 1 个月。对患者的人口统计学信息、乳腺癌手术和手部干预的类型、淋巴结清扫数量、原有淋巴水肿、淋巴水肿加重和新发淋巴水肿进行评估:共有161名患者接受了385次手部干预(300次注射、85次手术)。中位随访时间为 31 个月(范围:1-110)。19名患者在接受手部手术的同侧已有淋巴水肿,但没有人出现淋巴水肿加重的情况。三名患者在平均 30 个月的随访期间(范围:4-67),在手部干预手术的同侧出现了新发淋巴水肿。一名患者只接受了一次注射,5 年后出现了淋巴水肿。一名患者于同一天在同一只手上进行了 2 次注射,3 个月后出现淋巴水肿。第三位患者在右手进行了2次注射,在左手进行了1次注射和1次手术,注射1年后右手出现淋巴水肿或类风湿性关节炎引起的肿胀:结论:接受过乳腺癌手术的患者可以安全地接受上肢干预,淋巴水肿加重或发病的风险较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
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