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Published on: March 8, 2013
Lymphatic transfer studies with immunoglobulin scintigraphy after axillary surgery
S O'Mahony1, T M Bennett Britton, C K Solanki
1Cambridge Breast Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.
Summary
Axillary lymph node clearance surgery for breast cancer can cause unpredictable lymphatic system changes. An increased protein transfer to the blood pool is linked to developing breast cancer-related lymphedema (BCRL).
Area of Science:
- Oncology
- Surgical Oncology
- Lymphedema Research
Background:
- Axillary lymph node clearance is a standard breast cancer treatment.
- The surgery can impact the upper limb lymphatic system's function and morphology.
- Breast cancer-related lymphedema (BCRL) is a potential complication.
Purpose of the Study:
- To investigate the effects of axillary lymph node clearance surgery on lymphatic system function and morphology in breast cancer patients.
- To identify factors associated with the development of BCRL.
Main Methods:
- Scintigraphy was performed on 19 women before and after axillary lymph node clearance surgery (3 and 12 months post-op).
- Tc-99m-human polyclonal immunoglobulin was injected intradermally into the hand webspace.
- Lymphatic system function and morphology, including protein transit and blood pool activity, were assessed.
Main Results:
- Surgical effects on the lymphatic system showed significant functional variability.
- Seven patients developed BCRL.
- Increased blood pool activity post-surgery was observed, correlating with arm swelling and BCRL development.
- Lymph re-routing and protein transit velocity were not associated with BCRL.
Conclusions:
- The consequences of axillary lymph node clearance are variable, unexpected, and often persistent.
- An increased rate of protein access into the blood pool is significantly associated with BCRL.
- Further research is needed to understand and mitigate BCRL development.
