Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486357
Title: Lymphatic function in the arm following treatment for breast cancer
Author: Modi, Stephanie
Awarding Body: St George's, University of London
Current Institution: St George's, University of London
Date of Award: 2007
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Abstract:
Aims. The primary aim was to quantify changes in ann lymphatic function after axillary treatment for breast cancer. The hypotheses tested were that [1] impairment ofmuscle lymph drainage after axillary surgery precedes the onset of overt subcutaneous breast cancer related lymphoedema (BCRL); [2] regionality ofswelling in BCRL is due to . local regional impairment oflymph drainage; [3] the force oflymphatic collector pumping is weakened by the chronically raised afterload in BCRL anns. Methods. The removal rate constant, k, was used to measure local lymph drainage of 99mTc-HIG injected jnto the subcutis and muscle. Lymphatic collector pump force (Ppump) was assessed using a novellymphoscintigraphic method based on the escape of distally injected 99mTc-HIG under a pressurised upper ann cuff. Principal results. (i) No pre-BCRL reduction was found in kmusc/e (or ksubcutis) 7 months after surgery (ii) kwas faster in both anns ofnon-BCRL patients destined to develop BCRL compared with those who did not develop BCRL (ksubcutis by 37%, n =7, p = 0.0008; kmusc/e by 23%, P =0.035, n =7) (iii) In non-BCRL and mild BCRL anns kmusc/e was 2-3 fold faster than ksubcutis (p« 0.001, n ~ 26) (iv) ksubcutis was not significantly lower at sites ofmaximal swelling than minimal swelling in BCRL anns (v) proximal ksubcutis was 26 % faster than distal ksubcutiS (p = 0.02, n = 11) and correlated positively with ann circumference (r =0.32, p = 0.03, n = 44) irrespective ofBCRL (vi) P pump was reduced by 38% in BCRL anns relative to healthy anns (p = 0.014, n = 16 ofeach) and correlated negatively with foreann swelling (r =0.22, p = 0.011, n = 16). Conclusions. Non-BCRL patients with higher capillary filtration rates had an increased risk ofdeveloping BCRL. Weakening ofPpump was a factor contributing to BCRL. Proximal foreann subcutis lymph drainage was greater than in the distal foreann regardless of swelling, possibly due to faster muscle than subcutis lymph flow.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.486357  DOI: Not available
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