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Sentinel Node Biopsy Compared with Axillary Lymph Node Disse

PostPosted: Fri May 25, 2007 1:24 am
by patoco
Lymph Drainage Studied by Lymphoscintigraphy in the Arms after Sentinel Node Biopsy Compared with Axillary Lymph Node Dissection Following Conservative Breast Cancer Surgery.

Acta Radiol. 2007

Celebioglu F, Perbeck L, Frisell J, Gröndal E, Svensson L, Danielsson
R. Department of Molecular Medicine and Surgery, Karolinska Institute,
Karolinska University Hospital Solna, Stockholm, Sweden; Division of
Radiology, Department of Clinical Science, Intervention, and
Technology (CLINTEC), Karolinska Institute, Karolinska University
Hospital, Huddinge, Sweden; Medical Physics, Karolinska University
Hospital. Huddinge. Sweden.

Purpose: To investigate lymphatic drainage as measured by
lymphoscintigraphy in the arms of patients undergoing either sentinel
lymph node biopsy (SNB) or axillary lymph node dissection (ALND).

Material and Methods: From January 2001 to December 2002, 30 patients with unilateral invasive breast carcinoma underwent breast-conserving surgery with SNB and 30 patients with ALND. All patients received radiotherapy to the breast. Lymphoscintigraphy was performed, and skin circulation, skin temperature, and arm volume were measured 2-3 years after radiotherapy.

Results: None of the 30 patients who underwent SNB showed any clinical manifestation of lymphedema. Of the 30 patients undergoing ALND, six (20%) had clinical lymphedema, with an arm volume that was >10% larger on the operated than on the non-operated side (P<0.01).
Scintigraphically, visual analysis revealed lymphatic dysfunction in
three patients, manifested as forearm dermal back flow. Two of these
patients also had an increased arm volume. Quantitative analysis
showed no differences between the groups, apart from a smaller amount
of isotope in the axilla in the ALND group. There was no difference in
skin circulation or skin temperature.

Conclusion: Our study shows that lymph drainage in the operated arm compared with the non-operated arm was less affected by SNB than by ALND, and that morbidity associated with SNB was lower than with ALND.

However, the results do not confirm our hypothesis that
lymphoscintigraphy can reveal differences in lymph circulation that
are not evident clinically in the form of manifest lymphedema. The
most sensitive clinical method of assessing lymph drainage seems to be
measurement of arm volume.

PMID: 17520423 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/sites/entre ... tailView...

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Pat O'Connor
Lymphedema People
http://www.lymphedemapeople.com