O linfedema é uma patologia muito frequente em pacientes oncológicos. Nesse episódio eu foco em linfedema secundário ao câncer de mama, com revisão da definição, classificação, exames complementares e tratamentos bem estabelecidos, e algumas novidades no tema. Como sempre, a bibliografia está logo abaixo.

 

 

1.International Society of Lymphology . The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology 49 (2016) 170-184

2.Levenhagen K et al. Diagnosis of Upper-Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of APTA. Rehabil Oncol. 2017 Jul;35(3):E1-E18. doi: 10.1097/01.REO.0000000000000073. Epub 2017 Jun 30.

3.Nguyen TT et al. Breast Cancer-Related Lymphedema Risk is Related to Multidisciplinary Treatment and Not Surgery Alone: Results from a Large Cohort Study. Ann Surg Oncol. 2017 Oct;24(10):2972-2980. doi: 10.1245/s10434-017-5960-x. Epub 2017 Aug 1.

4.Asdourian MS . Association Between Precautionary Behaviors and Breast Cancer-Related Lymphedema in Patients Undergoing Bilateral Surgery. J Clin Oncol. 2017 Dec 10;35(35):3934-3941. doi: 10.1200/JCO.2017.73.7494. Epub 2017 Oct 4.

5.Ferguson CM. Impact of Ipsilateral Blood Draws, Injections, Blood Pressure Measurements, and Air Travel on the Risk of Lymphedema for Patients Treated for Breast Cancer. J Clin Oncol. 2016 Mar 1;34(7):691-8. doi: 10.1200/JCO.2015.61.5948. Epub 2015 Dec 7.

6.Ribeiro Pereira ACP et al. Incidence and risk factors of lymphedema after breast cancer treatment: 10 years of follow-up. Breast. 2017 Dec;36:67-73. doi: 10.1016/j.breast.2017.09.006. Epub 2017 Oct 6.

7.Ezzo J et al. Manual lymphatic drainage for lymphedema following breast cancer treatment. Cochrane Database Syst Rev. 2015 May 21;(5):CD003475. doi: 10.1002/14651858.CD003475.pub2.

8.Zhang L et al. Combining Manual Lymph Drainage with Physical Exercise after Modified Radical Mastectomy Effectively Prevents Upper Limb Lymphedema. Lymphat Res Biol. 2016 Jun;14(2):104-8. doi: 10.1089/lrb.2015.0036. Epub 2016 Jan 29.

9.Baumann FT et al. Effects of physical exercise on breast cancer-related secondary lymphedema: a systematic review. Breast Cancer Res Treat. 2018 Jul;170(1):1-13. doi: 10.1007/s10549-018-4725-y. Epub 2018 Feb 22.

10.Gatt M et al. A meta-analysis of the effectiveness and safety of kinesiology taping in the management of cancer-related lymphoedema. Eur J Cancer Care (Engl). 2017 Sep;26(5). doi: 10.1111/ecc.12510. Epub 2016 May 11.

11.Bao T et al. Acupuncture for breast cancer-related lymphedema: a randomized controlled trial. Breast Cancer Res Treat. 2018 Jul;170(1):77-87. doi: 10.1007/s10549-018-4743-9. Epub 2018 Mar 8.

12.Lyman GH et al. Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol. 2018 Jun 11:JCO2018792721. doi: 10.1200/JCO.2018.79.2721. [Epub ahead of print]

13.Baxter GD . Low level laser therapy (Photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review. BMC Cancer. 2017 Dec 7;17(1):833. doi: 10.1186/s12885-017-3852-x.

14.Bae H et al. Clinical outcomes of extracorporeal shock wave therapy in patients with secondary lymphedema: a pilot study. Ann Rehabil Med. 2013 Apr;37(2):229-34. doi: 10.5535/arm.2013.37.2.229. Epub 2013 Apr 30.

15.Cebicci MA et al. Extracorporeal Shock Wave Therapy for Breast Cancer-Related Lymphedema: A Pilot Study. Arch Phys Med Rehabil. 2016 Sep;97(9):1520-1525. doi: 10.1016/j.apmr.2016.02.019. Epub 2016 Mar 15.

16.Scaglioni MF1. Systematic review of lymphovenous anastomosis (LVA) for the treatment of lymphedema. Microsurgery. 2017 Nov;37(8):947-953. doi: 10.1002/micr.30246. Epub 2017 Oct 3.

A Síndrome de Dor Pós-Mastectomia acomete de 20-70% dos pacientes submetidos a uma cirurgia de mama. Nesse episódio eu discuto a definição, fatores de risco, apresentações clínicas e possíveis tratamentos.

 

 

Bibliografia

  1. Yang EJ et al. Longitudinal change of treatment-related upper limb dysfunction and its impact on late dysfunction in breast cancer survivors: a prospective cohort study. J Surg Oncol. 2010 Jan 1;101(1):84-91. doi: 10.1002/jso.21435.
  2. Richmond et al. Development of an exercise intervention for the prevention of musculoskeletal shoulder problems after breast cancer treatment: the prevention of shoulder problems trial (UK PROSPER). BMC Health Serv Res. 2018 Jun 18;18(1):463. doi: 10.1186/s12913-018-3280-x.
  3. Mejdahl MK et al. Persistent pain and sensory disturbances after treatment for breast cancer: six year nationwide follow-up study. BMJ. 2013;346:f1865. doi: 10.1136/bmj.f1865
  4. Pusic et al. Patient-Reported Outcomes 1 Year After Immediate Breast Reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium Study. J Clin Oncol. 2017
  5. Wisotzky E. Deconstructing Postmastectomy Syndrome: Implications for Physiatric Management. Phys Med Rehabil Clin N Am. 2017 Feb;28(1):153-169. doi: 10.1016/j.pmr.2016.09.003.
  6. Attal et al. Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2016 May;15(6):555-65. doi: 10.1016/S1474-4422(16)00017-X. Epub 2016 Mar 2.
  7. Wisotzky E. Ultrasound-Guided Intercostobrachial Nerve Block for Intercostobrachial Neuralgia in Breast Cancer Patients: A Case Series. PM R. 2016 Mar;8(3):273-7. doi: 10.1016/j.pmrj.2015.10.003. Epub 2015 Oct 19.
  8. Zocca et al. Pain Pract. 2017 Jan;17(1):141-146. doi: 10.1111/papr.12482. Epub 2016 Sep 2.
    Ultrasound-Guided Serratus Plane Block for Treatment of Postmastectomy Pain Syndromes in Breast Cancer Patients: A Case Series.
  9. Roth RS et al. Is chronic postsurgical pain surgery-induced? A study of persistent postoperative pain following breast reconstruction. Breast. (2018)
  10. Roth RS. Chronic postsurgical pain following breast reconstruction: a commentary and critique. Breast Cancer Res Treat. 2018 Jun;169(2):209-216. doi: 10.1007/s10549-018-4687-0. Epub 2018 Jan 30. Review.