Quantitative Lymphoscintigraphy to Predict the Possibility of Lymphedema Development After Breast Cancer Surgery: Retrospective Clinical Study
- Authors
- Kim, Paul; Lee, Ju Kang; Lim, Oh Kyung; Park, Heung Kyu; Park, Ki Deok
- Issue Date
- Dec-2017
- Publisher
- KOREAN ACAD REHABILITATION MEDICINE
- Keywords
- Breast cancer; Lymphedema; Lymphoscintigraphy; Quantitative assessment
- Citation
- ANNALS OF REHABILITATION MEDICINE-ARM, v.41, no.6, pp.1065 - 1075
- Journal Title
- ANNALS OF REHABILITATION MEDICINE-ARM
- Volume
- 41
- Number
- 6
- Start Page
- 1065
- End Page
- 1075
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/5434
- DOI
- 10.5535/arm.2017.41.6.1065
- ISSN
- 2234-0645
- Abstract
- Objective To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment. Methods This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups. Results Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04-0.46; p=0.001). Conclusion In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.
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