The Role of Elastography in Diagnosis and Staging of Breast Cancer-Related Lymphedema

İyigün, Zeynep Erdoğan; Agacayak, Filiz; İlgün, Ahmet Serkan; Çelebi, Filiz; Ordu, Çetın; Alço, Gül; Ozturk, Alper; Duymaz, Tomris; Aktepe, Fatma; Özmen, Vahit

doi:10.1089/lrb.2018.0012

Cited by 20 publications

(19 citation statements)

References 21 publications

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“…In our study, the forearm and arm stiffness values for the affected limbs of patients with clinical lymphedema were significantly higher than those of the contralateral limbs. The main difference between this study and that of Erdogan Iyigun et al was that their study focused on patients with clinical lymphedema (stages 1 and 2), and this study focused on both clinical and latent lymphedema.…”

Section: Discussionmentioning

confidence: 88%

“…Hayashi et al reported a moderate positive correlation between strain elastography and indocyanine green lymphography, which is used for diagnosing lymphatic obstructions. The data on the use of SWE for the diagnosis of lymphedema are limited . Chan et al found the SWV of the cutaneous and subcutaneous tissue of limbs with lymphatic obstruction to be significantly greater than that of unaffected limbs.…”

Section: Discussionmentioning

confidence: 99%

“…Chan et al found the SWV of the cutaneous and subcutaneous tissue of limbs with lymphatic obstruction to be significantly greater than that of unaffected limbs. Erdogan Iyigun et al evaluated the value of SWV in differentiating stage 1 and 2 lymphedema. Shear wave elastography was able to differentiate lymphedematous limbs on the basis of forearm but not arm measurements.…”

Section: Discussionmentioning

confidence: 99%

“…Axillary lymph node dissection for breast cancer treatment is the most common etiology of secondary upper limb lymphedema . Diagnosis is performed by clinical examination, limb circumferential and volumetric measurements, lymphoscintigraphy, indocyanine green lymphography, and analysis by bioimpedance spectroscopy (BIS) . Bioimpedance spectroscopy is a noninvasive tool that quantifies the extracellular water by measuring the tissue resistance to the flow of electrical current.…”

mentioning

confidence: 99%

“…Information about tissue stiffness is derived from the values for the speeds of those shear waves, which are expressed as the shear wave velocity (SWV) in meters per second. Given the fibrotic soft tissue changes of the affected limb in lymphedema, SWE could be useful in the diagnosis and monitoring of the disease …”

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confidence: 99%

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Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer–Related Lymphedema

Polat

Öztürk

POLAT

et al. 2019

J of Ultrasound Medicine

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Objectives To assess the feasibility of ultrasound and shear wave elastography (SWE) in the diagnosis of breast cancer–related lymphedema. Methods Forty‐one patients with a history of unilateral breast surgery and axillary dissection or sentinel lymph node excision were included in this prospective study. The patients were classified as having normal findings, latent lymphedema, and clinical lymphedema on the basis of a physical examination, lymphedema index scores, and limb circumference measurements. The thickness and stiffness of the cutaneous and subcutaneous tissue of the forearm and arm were measured by ultrasound and SWE. The thickness and stiffness of the cutaneous and subcutaneous tissue of the affected limb and contralateral limbs of the normal, latent lymphedema, and clinical lymphedema groups were compared. Results The mean age ± SD of the 41 patients was 55.42 ± 10.12 years. There were 15 patients with normal findings, 10 with latent lymphedema, and 16 with clinical lymphedema. In the latent lymphedema group, the thickness measurements of the cutaneous tissue of the affected forearm and the cutaneous and subcutaneous tissue of the affected arm were significantly greater than those of the contralateral forearm and arm (P = .034; P = .022; and P = .002, respectively), and the stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm were significantly greater than those of the contralateral forearm (P = .011; and P = .002). In the clinical lymphedema group, the thickness and stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm and arm were significantly greater than those of the contralateral limb (P < .001–P = .032). Conclusions Ultrasound and SWE are effective for diagnosing breast cancer–related lymphedema even at a latent stage.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer–Related Lymphedema

Polat

Öztürk

POLAT

et al. 2019

J of Ultrasound Medicine

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Supermicrosurgical Lymphaticovenular Anastomosis

Zeng

Gorrepati

Nieves

et al. 2021

Tips and Tricks in Plastic Surgery

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Microsurgical techniques in the treatment of breast cancer-related lymphedema: a systematic review of efficacy and patient outcomes

et al. 2021

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Introduction Secondary lymphedema is the abnormal collection of lymphatic fluid within subcutaneous structures. Patients with lymphedema suffer a low quality of life. In our study, we aim to provide a systematic review of the current data on patient outcomes regarding breast cancer-related lymphedema (BCRL), and the most prevalent reconstructive techniques. Methods A PubMed (MEDLINE) and Scopus literature search was performed in September 2020. Studies were screened based on inclusion/exclusion criteria. The protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO), and it was reported in line with the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Results The search yielded 254 papers from 2010 to 2020. 67 were included in our study. Lymphaticovenous anastomosis (LVA)—a minimally invasive procedure diverting the lymph into the dermal venous drainage system—combined with postoperative bandaging and compression garments yields superior results with minimal donor site lymphedema morbidity. Vascularized lymph node transfer (VLNT)—another microsurgical technique, often combined with autologous free flap breast reconstruction—improves lymphedema and brachial plexus neuropathies, and reduces the risk of cellulitis. The combination of LVA and VLNT or with other methods maximizes their effectiveness. Vascularized lymph vessel transfer (VLVT) consists of harvesting certain lymph vessels, sparing the donor site’s lymph nodes. Conclusion Together with integrated lymphedema therapy, proper staging, and appropriate selection of procedure, safe and efficient surgical techniques can be beneficial to many patients with BCRL.

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The Role of Elastography in Diagnosis and Staging of Breast Cancer-Related Lymphedema

Abstract: SWE should be a useful tool in diagnosis and distinguishing early and late stages of lymphedema.

Cited by 20 publications

References 21 publications

Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer–Related Lymphedema

Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer–Related Lymphedema

Supermicrosurgical Lymphaticovenular Anastomosis

Microsurgical techniques in the treatment of breast cancer-related lymphedema: a systematic review of efficacy and patient outcomes

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