Stanton, A. W. B., Modi, S., Britton, T. M. B., Purushotham, A. D., Peters, A. M., Levick, J. R., Mortimer, P. S. (2009) Lymphatic drainage in the muscle and subcutis of the arm after breast cancer treatment. BREAST CANCER RESEARCH AND TREATMENT, 117 (3). pp. 549-557. ISSN 0167-6806

Full text not available from this repository.

Abstract

Breast cancer-related lymphoedema of the arm (BCRL) results from impaired lymph drainage after axillary surgery. Little is known about lymphatic changes in the arm between surgery and oedema onset. We measured forearm muscle and subcutis lymph drainage in 36 women at 7 and 30 months after surgery by quantitative lymphoscintigraphy. None had BCRL initially but 19% had BCRL by 30 months. At 7 months muscle and subcutis drainage in both arms of BCRL-destined women exceeded that of non-BCRL women (P < 0.01). Muscle lymph drainage always exceeded subcutis drainage (P < 0.0001). Muscle lymph drainage in the ipsilateral arm was unimpaired relative to the contralateral arm. BCRL therefore developed in women with higher peripheral lymph flows. The major lymphatic load was generated by muscle; there was no pre-BCRL lymphatic impairment in the muscle of the ipsilateral arm. We propose that some women have a defined, constitutive predisposition to secondary lymphoedema. Specifically, women with higher filtration rates, and therefore higher lymph flows through the axilla that are closer to the maximum sustainable, are at greater risk of BCRL following axillary trauma, even following removal of 1-2 nodes.

Item Type:	Article
All Authors:	Stanton, A. W. B., Modi, S., Britton, T. M. B., Purushotham, A. D., Peters, A. M., Levick, J. R., Mortimer, P. S.
Uncontrolled Keywords:	Arm; Breast cancer; Lymphatic; Lymphoedema; Lymphoscintigraphy; Lymph flow;POSTMASTECTOMY EDEMA; NODE BIOPSY; AXILLARY DISSECTION; LYMPHEDEMA; WOMEN; LYMPHOSCINTIGRAPHY; SWOLLEN; DENSITY; TRIAL; RISK
Funding Acknowledgement:	Wellcome Trust [063025]; Frances and Augustus Newman Foundation
Funding Text:	We thank the patients, Mr G. Querci della Rovere ( Royal Marsden Hospital, Sutton), Mr A. K. Sharma ( St George's Hospital, London) for access to the patients; Dr R. Allan ( St George's Hospital) for holding the ARSAC certificate; A. Irwin ( St George's Hospital) for physics support; and J. Ballinger ( Guy's Hospital, London) and M. Wilkinson ( St George's Hospital) for radiopharmacy support. Grant support: We thank the Wellcome Trust ( grant number 063025 awarded to P. S. Mortimer) and the Frances and Augustus Newman Foundation ( equipment grant).
Research teams:	Clinical Units > Other Royal Marsden Services/Clinical Units
Depositing User:	Users 10 not found.
Date Deposited:	02 Oct 2009 14:42
Last Modified:	20 Nov 2009 10:11
URI:	http://publications.icr.ac.uk/id/eprint/8811

Actions (login required)

View Item