Imaging techniques in the management and prevention of posttherapeutic upper limb edemas

Abstract

Various imaging techniques can be used to prevent and/or to manage the upper limb edema that may complicate the treatment(s) of the patients with breast carcinoma.

Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

“…26 Lymphoscintigraphy, a nuclear medicine imaging technique, along with other imaging technologies, have been used to investigate the pre-and post-operative risk of lymphoedema development in patients with breast cancer. [27][28][29] The uptake of this imaging modality in the clinical diagnostic process is not universal 30 and is the topic of continuing experimental evaluation. 31 New technologies such as bioimpedance may aid diagnosis and provide a level of accuracy in clinical examination not previously possible through traditional measurement techniques such as circumferential measures.…”

Physiotherapeutic stimulation: Early prevention of lymphedema following axillary lymph node dissection for breast cancer treatment

“…Fifty percent of breast cancer cases are diagnosed at an advanced stage and include lymph node metastatic infiltration, necessitating more aggressive and costly treatment (3) and increasing the risk of post-treatment complications (4)(5)(6)(7)(8).…”

“…Aggressive surgery in advanced stage breast cancer cases interrupts the main lymphatic drainage route in the upper limbs and is the most important factor in the formation of lymphedema (5). The pathogenesis of post-mastectomy lymphedema associated with axillary dissection is in particular attributed to the small number of lymphatic vessels in the dissected area (9,10).…”

“…The prevention of lymphedema has been attempted using intraoperative techniques that take a more conservative approach towards the axillary chain, such as the investigation of the sentinel lymph nodes. Through this, selective resection that is safe and less mutilating becomes possible, with satisfactory results, although it is limited to patients without evidence of lymph node macrometastasis (5,7,(15)(16)(17).…”

“…This is followed by gentle movements at a site distant from the area of congestion, moving gradually towards the swollen limb (12,18,22,23). lymphoscintigraphy is an effective technique for evaluating the lymphatic systems of the upper and lower limbs (5,24,25). It provides functional information regarding drainage and obstruction in this system, with details on the morphology of the lymph vessels and lymph nodes (26).…”