Supervisors info:
Αφροδίτη Νόννη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ (Επιβλέπουσα)
Χαρά Γακιοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μιχάλης Κοντός, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Lymphedema refers to the clinical manifestation of mechanical insufficiency of the lymphatic system. It is the most feared side effect after breast cancer surgery (surgical removal of the axillary lymph nodes, radiotherapy, chemotherapy) and can occur immediately, usually within the first two years after initial treatment, or up to 30 years later. It is estimated that about 20% of patients will develop some form of lymphedema, depending on the stage of the cancer and the type of treatment. Factors associated with the likelihood of occurrence are the type and technique of surgery, radiation, the number of lymph nodes removed, the presence of infiltrated lymph nodes, and the patient's previous condition (eg, increased body weight, history of infection). Lymphedema is usually manifested by a feeling of heaviness, swelling of the limb, discomfort and reduced functionality. As a chronic condition, the affected area gradually undergoes secondary lesions, such as hardening, fibrosis, and thickening of the skin with a propensity for inflammation. It is imperative, therefore, to make an early diagnosis by taking a good history, measuring the circumference using a tape measure, biometric methods and imaging techniques, such as lymphoscintigraphy, lymphοgraphy with green indocyanine, ultrasound, computed tomography and magnetic resonance imaging. The treatment method is conservative and the modern treatment used is Complete Decongestive Therapy(CDT), which includes manual lymphatic drainage in combination with compression bandags, use of compression garment and elastic band, as well as special exercises, skin care and body weight regulation, in order to drain the edema and maintain the results of the treatment. Surgical treatment is chosen only in case of failure of all other interventions. However, recently. there have been suggestions for its immediate implementation during surgery to treat cancer itself, with the aim of eliminating lymphedema. Last but not least, advances in technology help to understand this disease, providing the opportunity for new methods of treatment and better prevention.
Keywords:
Lymphoedema, Breast cancer, Diagnosis, Management, Symptoms
