ABOUT OF THE PATHOGENESIS AND MEASURES TO MINIMIZE LONG PERSISTENT POSTOPERATIVE LYMPHORRHEA IN BREAST CANCER PATIENTS
Original research article
Published August 28, 2023
Keywords
breast cancer
lymphorrhea
comorbidity
lymphorrhea
comorbidity
How to Cite
Grushina T. I., Zhavoronkova V. V., Starkova M. V., Turova E. A. ABOUT OF THE PATHOGENESIS AND MEASURES TO MINIMIZE LONG PERSISTENT POSTOPERATIVE LYMPHORRHEA IN BREAST CANCER PATIENTS // Kremlin Medicine Journal. 2023. VOL. № 3. С. 18-22.
Abstract
Surgery in patients with breast cancer (BC) is associated with the risk of various complications, including predictable lymphorrhea after regional axillary lymphadenectomy and transection of lymphatic vessels. The pathogenesis of prolonged lymphorrhea with the formation of postoperative seromas is not known for certain until now. The aim. Study the factors that increase the risk of prolonged postoperative lymphorrhea in patients with breast cancer (BC). Methods. A retrospective analysis of medical records of 1938 women with breast cancer aged 20 to 71 years who underwent anticancer treatment was carried out. We studied the statistical dependence of the incidence of prolonged postoperative lymphorrhea on a number of factors: age, breast cancer stage, type of treatment, comorbid pathology. Results. Prolonged lymphorrhea was detected in 26.1% of cases. The frequency of prolonged postoperative lymphorrhea increases: the presence in patients of concomitant hypertension (p = 0.03), chronic venous insufficiency (p = 0.006), metabolic diseases (p = 0.01), age of patients (p = 0.041) with an upward age trend with a maximum frequency (34.3%) lymphorrhea during menopause. The frequency of prolonged lymphorrhea is not affected by the stage of breast cancer (p = 0.056), the type of surgery (p > 0.05) and the method of neoadjuvant treatment (p > 0.05). Conclusions. The frequency of long-term postoperative lymphorrhea is not affected by the stage of breast cancer, the type of surgery and the method of neoadjuvant treatment, but its frequency is increased by the presence in patients of concomitant cardiovascular diseases, metabolic diseases (obesity, diabetes mellitus) caused by hormonal regulation disorders and the development of endothelial dysfunction during menopauseReferences
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4. Ebner F. et al. Seroma in breast surgery: all the surgeons fault? // Arch. Gynecol. Obstet. – 2018. – V. 298. – № 5. – P. 951–959.
5. Bogdanov A.V. et al. Prevention of prolonged and profuse lymphorrhea in breast cancer // Oncology. P.A. Herzen Journal. – 2020. – V. 9. – № 3. – P. 34–40. In Russian.
6. Contreras N. et al. The achilles heel of minimally invasive inguinal lymph node dissection: seroma formation // Am J Surg. – 2020. – V. 219. – № 4. – P. 696–700.
7. Van Bastelaar J. et al. Analysis of TNF-α and interleukin-6 in seroma of patients undergoing mastectomy with or without flap fixation: is there a predictive value for seroma formation and its sequelae? // Surg Oncol. – 2019. – № 28. – P. 36–41.
8. Pak D.D. et al. Lymphorrhea after radical mastectomies // Russian journal of oncology. – 2011. – № 2. – P. 35–40. In Russian.
9. Korneev K.V. et al. Intraoperative methods of lymphorrea prevention after surgical treatment of breast cancer // Bulletin of the Russian Scientific Center of Radiology. – 2013. – V. 13. – № 1. – P. 4. In Russian.
10. Sforza M. et al. Unraveling factors influencing early seroma formation in breast augmentation surgery // Aesthet Surg J. – 2017. – V. 37. – № 3. – P. 301–307.
11. Vasileiadou K. et al. Cyanoacrylate adhesive reduces seroma production after modified radical mastectomy or quadrantectomy with lymph node dissection – a prospective randomized clinical trial // Clin Breast Cancer. – 2017. – V. 17. – № 8. – P. 595–600.
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13. Кузнецова И.В. Эндотелиальная дисфункция как связующее звено климактерического синдрома и сердечно-сосудистых заболеваний // Эффективная фармакотерапия. – 2019. – Т. 15. – № 32. – С. 32–40. [Kuznetsova I.V. Endothelial dysfunction as a link between climacteric syndrome and cardiovascular diseases // Effective pharmacotherapy. – 2019. – V. 15. – № 32. – P. 32–40. In Russian].
14. Morfoisse F. et al. Sex hormones in lymphedema // Cancers. – 2021. – № 13. – P. 530.
15. Тюренков И.Н. и др. Эндотелиопротекторы – новый класс фармакологических препаратов // Вестник РАМН. – 2012. – № 7. – С. 50–57. [Tyurenkov I.N. et al. Endothelial protection drugs – a new class of pharmacological agents // Bulletin of the Russian Academy of Medical Sciences. – 2012. – № 7. – P. 50–57. In Russian].