RESUMO
BACKGROUND: Certain treatments increase lymphedema risk in breast cancer survivors. The purpose of this study was to determine whether quality of life improved with preoperative teaching by a lymphedema expert. METHODS: Preoperative breast cancer patients were prospectively randomized into intervention group 1 or control group 2. Group 1 had a discussion with the lymphedema expert and at 6 months, in addition to the preoperative surgical discussion and literature given to all. Arm measurements and quality of life evaluation with Functional Assessment of Cancer Therapy-Breast Cancer were completed preoperatively and at intervals for up to 3 years. Lymphedema was verified with a 10% increase in volume or circumference. Univariate and multivariate analysis were performed on data. RESULTS: There were 119 evaluable patients with no differences between groups 1 and 2. The rate of acute lymphedema was 51.5% (33 of 64) for group 1 and 47.2% (26 of 55) for group 2. Chronic lymphedema presented in 13 patients (9.3% group 1 and 12.7% group 2). Lymphedema was significantly associated with number of lymph nodes resected (P < .001). Significant findings in the Functional Assessment of Cancer Therapy-Breast Cancer were at 6 months for all and after diagnosis in lymphedema positive patients. CONCLUSION: Structured lymphedema teaching can help to improve quality of life in lymphedema patients.
Assuntos
Neoplasias da Mama/cirurgia , Sobreviventes de Câncer/psicologia , Excisão de Linfonodo/efeitos adversos , Linfedema/terapia , Mastectomia/efeitos adversos , Educação de Pacientes como Assunto/métodos , Adulto , Idoso , Neoplasias da Mama/patologia , Doença Crônica , Feminino , Seguimentos , Humanos , Excisão de Linfonodo/métodos , Linfedema/etiologia , Linfedema/fisiopatologia , Linfedema/psicologia , Mastectomia/métodos , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Estudos Prospectivos , Resultado do TratamentoRESUMO
This article describes several methods for breast cancer ablation. It focuses especially on radiofrequency ablation, describing how it works, relate findings from recent studies, and comparing it with other methods of breast cancer ablation.
Assuntos
Neoplasias da Mama/cirurgia , Ablação por Cateter , Criocirurgia , Neoplasias da Mama/patologia , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Criocirurgia/métodos , Feminino , Fibroadenoma/cirurgia , Humanos , Mastectomia Segmentar , Terapia por Ultrassom/métodos , Ultrassonografia de IntervençãoRESUMO
BACKGROUND: Lymphedema may be identified by simpler circumference changes as compared with changes in limb volume. METHODS: Ninety breast cancer patients were prospectively enrolled in an academic trial, and seven upper extremity circumferences were measured quarterly for 3 years. A 10% volume increase or greater than 1 cm increase in arm circumference identified lymphedema with verification by a lymphedema specialist. Sensitivity and specificity of several different criteria for detecting lymphedema were compared using the academic trial as the standard. RESULTS: Thirty-nine cases of lymphedema were identified by the academic trial. Using a 10% increase in circumference at two sites as the criterion, half the lymphedema cases were detected (sensitivity 37%). When using a 10% increase in circumference at any site, 74.4% of cases were detected (sensitivity 49%). Detection by a 5% increase in circumference at any site was 91% sensitive. CONCLUSIONS: An increase of 5% in circumference measurements identified the most potential lymphedema cases compared with an academic trial.