Quantitative Lymphoscintigraphy to Predict the Possibility of Lymphedema Development After Breast Cancer Surgery: Retrospective Clinical Study.
10.5535/arm.2017.41.6.1065
- Author:
Paul KIM
1
;
Ju Kang LEE
;
Oh Kyung LIM
;
Heung Kyu PARK
;
Ki Deok PARK
Author Information
1. Department of Rehabilitation Medicine, Gachon University Gil Medical Center, Incheon, Korea. bduck@gachon.ac.kr
- Publication Type:Original Article
- Keywords:
Breast cancer;
Lymphedema;
Lymphoscintigraphy;
Quantitative assessment
- MeSH:
Axilla;
Breast Neoplasms*;
Breast*;
Clinical Study*;
Follow-Up Studies;
Hand;
Humans;
Lymph Nodes;
Lymphatic System;
Lymphedema*;
Lymphoscintigraphy*;
Radioactivity;
Retrospective Studies*;
Unilateral Breast Neoplasms
- From:Annals of Rehabilitation Medicine
2017;41(6):1065-1075
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment. METHODS: This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups. RESULTS: Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04–0.46; p=0.001). CONCLUSION: In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.
