Risk Factors leading to the development of lymphedema
Lymphedema is a side effect of cancer treatmentbreast. According to various sources, with lymphedema of the upper limbs are facing 20% to 80% of women who have had breast cancer and has already passed a full course of treatment. Unfortunately, at the beginning of treatment to predict the exact risk of this complication is very difficult. It all depends on the patient's condition, the volume of operations and other treatments to be applied afterwards.
Lymphedema is the reason that in stepon breast cancer in women are often removed lymph nodes in their defeat or for the prevention of cancer recurrence. The consequence of this, as well as subsequent therapy (exposure to radiation axilla) is a violation of lymphatic drainage from the area of the hand, which is manifested by edema of soft tissues. This condition is not particularly dangerous or fatal, but can last long enough. Lymphedema - a cluster of lymph in the soft tissues of the upper limb. In areas of the feet can also be lymphedema, but this condition is associated with other diseases already.
The mechanism of development lymphostasis with breast surgery
Lymph - a colorless liquid, which is the sameas blood circulates in the body. But unlike blood, it does not flow in the arteries and veins, and in thin lymphatic vessels. The function of lymph in the body - cleansing. Purification of the lymphatic system of the organism is as follows. Lymph collects decay products and other substances from the tissues and delivers them to the "Filter" - the lymph nodes, which are scattered throughout the human body. Ultimately lymphatics flow into two major veins, located near the heart, thus returning the lymph to the blood stream, where further processed and delivered to the organs of excretion.
In addition to the cleansing function in the lymph and manyothers. I should say that the lymph is rich in protein. Unlike the circulatory system where the blood is driven by contractions of the heart muscle, the lymphatic system does not have a central "pumping station". Lymph circulates through the reduction of skeletal and respiratory muscles. But circulation of this rather slow in most parts of the body movement occurs against the force of gravity, covering the whole vast network of tiny capillaries, called lymph. These tiny vessels with very thin walls permeate the entire human body, but particularly large number of them in the subcutaneous tissue. Furthermore, in the lymphatic vessels have valves that prevent lymph flow away in the opposite direction.
When surgical procedures in the field ofarmpits, where the main regional lymph nodes, the doctor, removing lymph nodes, willy-nilly, damage lymphatic vessels. As a result, lymph can not flow away from the soft tissues of hands and its stagnation occurs. This is manifested by the fact that lymph accumulates in the skin, adipose tissue, muscles, nerves, and connective tissue. This lymphedema can affect how the whole hand, and part of it, for example, the hand, forearm or shoulder. Additionally, Lymphedema can affect not only the hand, but also the chest, on the side where the operation was carried out, since the upper outer part of the breast gives lymph drainage to the regional axillary lymph nodes.
It should be noted that some patients of lymphedema can be very indistinct, so that it can be hardly noticed, and some this state may be strongly expressed.
Surgery for removal of the lymph nodesaxilla (in conjunction with mastectomy - removal of the breast) increases the risk of developing a certain degree of lymphedema. The irradiation area of axillary lymph nodes and chemotherapy may further increase this risk. If not lymphoedema after treatment of breast cancer, it means that the body until it copes with the load that it is experiencing. However, in any case, it is important to avoid the causes which lead to the development lymphostasis.
One of the "novelties" in the method of removing the lymph nodesoncology surgery is the removal of the so-called signaling nodes. This method provides an alternative to standard axillary lymph node dissection. It is believed that this operation allows you to avoid serious side effects inherent in the art of the traditional removal of lymph nodes. Unfortunately, this type of intervention is shown not all patients suffering from breast cancer. With this method the surgeon removes only the lymph nodes, which are really affected. This avoids damage to the whole and healthy lymphatic vessels, and thus significantly reduce the risk of developing lymphedema.