Alterações venosas e linfáticas em mulheres com linfedema após linfadenectomia axilar no tratamento do câncer de mama
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2013
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Resumo
PURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema
after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women
with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was
carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the
period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence
of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in
both upper limbs. Fisher’s exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume
in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of
the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with
a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic
changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph
nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic
alterations were encountered. CONCLUSION: The women subjected to axillary lymphadenectomy for the treatment of
breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.
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Palavras-chave
Linfedema, Neoplasias da mama, Ultrassonografia doppler, Cintilografia, Lymphedema, Ultrasonography, doppler, Breast neoplasms, Radionuclide imaging
Citação
VALINOTE, Sarah Patrizia Araújo et al. Alterações venosas e linfáticas em mulheres com linfedema após linfadenectomia axilar no tratamento do câncer de mama. Revista Brasileira de Ginecologia e Obstetrícia, São Paulo, v. 35, n. 4, p. 171-177, 2013.