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Lymphoscintigraphic Investigations for Axillary Web Syndromes

BACKGROUND: Axillary web syndrome (AWS) is a frequent complication after surgery for breast cancer, but its lymphatic involvement is not definitively established. Here we report the results of lymphoscintigraphic investigations in patients with AWS. METHODS AND RESULTS: We conducted a retrospective,...

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Autores principales: Roman, Mirela Mariana, Barbieux, Romain, Eddy, Christine, Karler, Clarence, Veys, Isabelle, Zeltzer, Assaf, Adriaenssens, Nele, Leduc, Olivier, Bourgeois, Pierre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422805/
https://www.ncbi.nlm.nih.gov/pubmed/34813367
http://dx.doi.org/10.1089/lrb.2021.0015
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author Roman, Mirela Mariana
Barbieux, Romain
Eddy, Christine
Karler, Clarence
Veys, Isabelle
Zeltzer, Assaf
Adriaenssens, Nele
Leduc, Olivier
Bourgeois, Pierre
author_facet Roman, Mirela Mariana
Barbieux, Romain
Eddy, Christine
Karler, Clarence
Veys, Isabelle
Zeltzer, Assaf
Adriaenssens, Nele
Leduc, Olivier
Bourgeois, Pierre
author_sort Roman, Mirela Mariana
collection PubMed
description BACKGROUND: Axillary web syndrome (AWS) is a frequent complication after surgery for breast cancer, but its lymphatic involvement is not definitively established. Here we report the results of lymphoscintigraphic investigations in patients with AWS. METHODS AND RESULTS: We conducted a retrospective, single-center review of lymphoscintigraphic investigations performed in 46 patients with AWS that was either clinically obvious or suspected. Of this group, 23 patients had two investigations with a mean interval of 19 weeks between them (range, 6–98 weeks). Results of the lymphoscintigraphic investigations, which were performed according to a well-standardized protocol, were classified into four patterns: normal; functional lymphatic insufficiency only (no lymphatic vascular morphologic abnormality); lymphovascular blockade without collateralization; and vascular collateralization and/or dermal backflow. Of the 46 patients, on the first lymphoscintigraphic investigation, four (8.6%) had a normal pattern, seven (15.2%) had functional lymphatic insufficiency only, four (8.6%) had lymphovascular blockade without collateralization, and 31 (67.3%) had vascular collateralization and/or dermal backflow. Among patients who underwent two investigations, four of the five who had only functional lymphatic insufficiency at the first investigation had developed vascular collateralization and/or dermal backflow by the second. The three patients who had lymphovascular blockade without collateralization at the first examination had also progressed to collateralization and/or dermal backflow at the second. None of the 15 patients who initially had vascular collateralization and/or dermal backflow showed any reversal at the second examination. CONCLUSIONS: Our analysis confirms the lymphatic nature of AWS and shows the lymphoscintigraphic patterns and evolutions of the lymphatic lesions with potential therapeutic implications. The retrospective review of our database is approved by the institutional ethics committee under number 2048.
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spelling pubmed-94228052022-08-30 Lymphoscintigraphic Investigations for Axillary Web Syndromes Roman, Mirela Mariana Barbieux, Romain Eddy, Christine Karler, Clarence Veys, Isabelle Zeltzer, Assaf Adriaenssens, Nele Leduc, Olivier Bourgeois, Pierre Lymphat Res Biol Original Articles BACKGROUND: Axillary web syndrome (AWS) is a frequent complication after surgery for breast cancer, but its lymphatic involvement is not definitively established. Here we report the results of lymphoscintigraphic investigations in patients with AWS. METHODS AND RESULTS: We conducted a retrospective, single-center review of lymphoscintigraphic investigations performed in 46 patients with AWS that was either clinically obvious or suspected. Of this group, 23 patients had two investigations with a mean interval of 19 weeks between them (range, 6–98 weeks). Results of the lymphoscintigraphic investigations, which were performed according to a well-standardized protocol, were classified into four patterns: normal; functional lymphatic insufficiency only (no lymphatic vascular morphologic abnormality); lymphovascular blockade without collateralization; and vascular collateralization and/or dermal backflow. Of the 46 patients, on the first lymphoscintigraphic investigation, four (8.6%) had a normal pattern, seven (15.2%) had functional lymphatic insufficiency only, four (8.6%) had lymphovascular blockade without collateralization, and 31 (67.3%) had vascular collateralization and/or dermal backflow. Among patients who underwent two investigations, four of the five who had only functional lymphatic insufficiency at the first investigation had developed vascular collateralization and/or dermal backflow by the second. The three patients who had lymphovascular blockade without collateralization at the first examination had also progressed to collateralization and/or dermal backflow at the second. None of the 15 patients who initially had vascular collateralization and/or dermal backflow showed any reversal at the second examination. CONCLUSIONS: Our analysis confirms the lymphatic nature of AWS and shows the lymphoscintigraphic patterns and evolutions of the lymphatic lesions with potential therapeutic implications. The retrospective review of our database is approved by the institutional ethics committee under number 2048. Mary Ann Liebert, Inc., publishers 2022-08-01 2022-08-22 /pmc/articles/PMC9422805/ /pubmed/34813367 http://dx.doi.org/10.1089/lrb.2021.0015 Text en © Mirela Mariana Roman et al. 2022; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by-nc/4.0/This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License [CC-BY-NC] (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are cited.
spellingShingle Original Articles
Roman, Mirela Mariana
Barbieux, Romain
Eddy, Christine
Karler, Clarence
Veys, Isabelle
Zeltzer, Assaf
Adriaenssens, Nele
Leduc, Olivier
Bourgeois, Pierre
Lymphoscintigraphic Investigations for Axillary Web Syndromes
title Lymphoscintigraphic Investigations for Axillary Web Syndromes
title_full Lymphoscintigraphic Investigations for Axillary Web Syndromes
title_fullStr Lymphoscintigraphic Investigations for Axillary Web Syndromes
title_full_unstemmed Lymphoscintigraphic Investigations for Axillary Web Syndromes
title_short Lymphoscintigraphic Investigations for Axillary Web Syndromes
title_sort lymphoscintigraphic investigations for axillary web syndromes
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422805/
https://www.ncbi.nlm.nih.gov/pubmed/34813367
http://dx.doi.org/10.1089/lrb.2021.0015
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