47th Congress of European Society of Lymphology, İstanbul, Türkiye, 30 Mayıs - 02 Haziran 2024, ss.1, (Özet Bildiri)
INTRODUCTION:
Breast cancer is the most common type of cancer in women
worldwide, representing 25% of all cancers. Breast-conserving surgery (BCS) and
radiotherapy after lymph node biopsy are widely used in the treatment of breast
cancer. In some patients, breast edema occurs in the breast that has undergone
surgery and radiotherapy.
CASE:
46-year-old female patient; On the 10th day of radiotherapy,
she applied to the outpatient clinic with complaints of swelling, heaviness and
redness in her left breast. In the patient who had left breast-conserving
surgery 1.5 months ago and had 5 lymph nodes excised and sentinel lymph node
biopsy performed, breast edema, redness, and pore enlargement in the breast
skin were detected on the 10th day of radiotherapy.
In physical examination; In the upper extremity
circumference measurements made with a tape measure at standard points, no
significant difference in circumference was detected on the left side compared
to the right side (<1 cm). Again, using a
measure, the chest circumference was determined as 114 cm. No limitation
was detected in the patient's shoulder joint range of motion. Objective edema,
fibrosis, redness, and enlargement of breast skin pores were detected in the
patient's left breast. Examination findings of other systems were normal. Complex
decongestive therapy including 20 sessions of manual lymph drainage,
self-drainage and exercise training was applied. Treatment was terminated with
self-drainage, exercise and protection recommendations.
RESULTS:
Picture 1: Skin
pores appearance before and after complex decongestive therapy
Table 1: Breast volume circumference measurement
Before Treatment |
114 cm |
10th seance |
112 cm |
3 Months After Radiotherapy (After 20
Seance) |
112 cm |
CONCLUSIONS:
• Breast-conserving surgery with lymph node biopsy causes
damage to the lymphatic pathways not only in the upper extremity but also in
the breast.
• The risk of developing breast edema increases due to
radiotherapy following breast-conserving surgery in which lymph node biopsy is
performed.
• The importance of early intervention in breast edema
during radiotherapy should be taken into consideration.
• Complex decongestive therapy is effective in the
treatment of breast edema, which may occur in patients who have undergone
breast-conserving surgery and received adjuvant radiotherapy.