scholarly journals A CASE OF CHYLOUS FISTULA FOLLOWING DISSECTION OF THE AXILLARY LYMPH NODES DURING BREAST CANCER SURGERY

2009 ◽  
Vol 70 (4) ◽  
pp. 1002-1005
Author(s):  
Futoshi KAWAHARA ◽  
Tomoko UEJIMA ◽  
Kyouko TSUCHIYA ◽  
Arata SHIMO ◽  
Yukari YABUKI ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Chylous Fistula

scholarly journals The Findings of SPECT/CT Concerning Bypass Lymph Circulation in Lymphedema Following Breast Cancer Surgery

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 471
Author(s):  
Min Young Lee ◽  
Eunjung Kong ◽  
Dong Gyu Lee
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymphatic Drainage ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Positive Group

This study aimed to determine whether bypass circulation was present in lymphedema and its effect. This was a retrospective, cross-sectional study. Patients who underwent unilateral breast cancer surgery with axillary lymph node dissection were recruited and underwent single-photon emission tomography/computed tomography (SPECT/CT). SPECT/CT was performed to detect the three-dimensional locations of radio-activated lymph nodes. Patients with radioactivity in anatomical locations other than axillary lymph nodes were classified into a positive group. All patients received complete decongestive therapy (CDT). Exclusion criteria were as follows: History of bilateral breast cancer surgery, cervical lymph node dissection history, and upper extremity amputation. The difference in the upper extremity circumference (cm) was measured at four points: Mid-point of the upper arm, elbow, and 10 and 15 cm below the elbow. Twenty-nine patients were included in this study. Fifteen patients (51.7%) had bypass lymphatic systems on the affected side, six (20.7%) had a bypass lymphatic system with axillary lymph nodes on the unaffected side, and 11 (37.9%) showed new lymphatic drainage. The positive group showed significantly less swelling than the negative group at the mid-arm, elbow, and 15 cm below the elbow. Bypass lymphatic circulation had two patterns: Infraclavicular lymph nodes and supraclavicular and/or cervical lymph nodes. Changes in lymph drainage caused by surgery triggered the activation of the superficial lymphatic drainage system to relieve lymphedema. Superficial lymphatic drainage has a connection through the deltopectoral groove.

scholarly journals Sentinel lymph node biopsy in breast cancer surgery

2011 ◽  
Vol 2 (2) ◽  
pp. 101-112
Author(s):  
Mario Taffurelli
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Lymphatic System ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph

Axillary lymph node status is one of the most reliable prognostic factors of long-term survival in breast cancer surgery. Metastatic involvement of the axillary lymph nodes is also crucial in the decision making of potentially useful adjuvant treatment. Until the last decade, Axillary Lymph Nodes Dissection (ALND) was performed in order to obtain the regional lymphatic system staging. In case of non-metastatic spread, that kind of surgery was limited only to this purpose; no further oncological benefits were obtained and the patients were exposed to several comorbidities affecting this type of surgery. Complications after ALND are reported in 15-30% of cases. They are well known and range from early bleeding, infection, symptomatic nerve damage, and longstanding limb lymph-edema with an incredible impairment of the quality of life.The Sentinel Lymph Node (SLN) theory holds that the SLNs are the first nodes draining lymph from an anatomic region (i.e. the breast) where metastatic disease will most likely to be found. If that node is found to be cancer free, the entire lymphatic system is likely to be cancer free; if it is metastatic, there is an elevated chance of finding more metastatic nodes. Thanks to the application of this hypothesis, several patients over the last 10-15 years have avoided unnecessary major demolitive surgery. To obtain accurate evaluation of the SLN a multidisciplinary dedicated team is necessary. This procedure has been internationally validated and the false negative rate is nowadays less than 5% when performed by expert hands. Dedicated breast surgeons working in a high-volume centres are necessary to reach satisfactory confidence in performing this very specialised procedure in order to obtain an accurate staging. The number of women presenting to the breast oncology units is continuously increasing and the implementation of screening programs has been crucial in detecting numerous patients (more than 75%) with early disease and non-metastatic axillary lymph nodes. The practice of the SLN is clearly able to offer those patients an accurate staging with low comorbidities, preserving their quality of life.

scholarly journals Assessment of axillary lymph nodes involvement in patients with breast cancer depending on the tumor size and its histological and nuclear grades

2012 ◽  
Vol 69 (5) ◽  
pp. 414-419 ◽  
Author(s):  
Toplica Bojic ◽  
Nebojsa Djordjevic ◽  
Aleksandar Karanikolic ◽  
Sladjana Filipovic ◽  
Miroslav Granic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Histological Grade ◽  
Radical Mastectomy ◽  
Nuclear Grade ◽  
Breast Cancer Surgery ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients

Background/Aim. There are a lot of studies aiding to the opinion that the involvement degree of axilla lymph nodes grows depending on increase of breast tumor size, and its histological and nuclear grades. The aim of this study was to assess the risk of axillary lymph nodes involvement, as well as the relation between the tumor size, histological and nuclear grades in a group of female patients who underwent breast cancer surgery, including levels 1-3 axillary dissection. Methods. Investigation covered 900 patients operated on during 2005-2008 who underwent modified radical mastectomy including axillar dissection. We assessed a number of involved lymph nodes, depending on tumor macroscopic size (T), histological grade (HG) and nuclear grade (NG). Results. A total number of examined lymph nodes was 9977. The incidence of involved lymph nodes was from 18.6% with T1 tumor size up to 60.2% with T4 tumor size. Concerning histological grade, the number of involved lymph nodes ranged from 14.2% (HGI) to 45.1% (HGIII); while in terms of nuclear grade, the number of involved lymph nodes ranged from 17.4% (NGI) to 54.5% (NGIV). By using ?2-test for trend and odds ratio (OR), the results showed that the axillary lymph nodes involvement degree was increased with the increase of the tumor size and its histological and nuclear grades. The risk of axillary lymphatic nodes involvement was 1.43 times higher in the group of T2 tumors size compared to the smaller tumors T1 size, and even up to 6.62 times higher in case of T4 tumor size. It was also increasied from 1.79 times for HGII to even 4.98 times for HGIII, and from 1.44 times for NGII to 5.71 times for NGIV. Conclusion. In breast cancer patients, there is a strong correlation between tumor size, its histological and nuclear grades and the risk of axillary lymph nodes involvement.

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