Article

OBJECTIVE: To systematically assess the incidence/prevalence and time path of
lymphedema in patients with sentinel node-negative breast cancer. DATA SOURCES: A
systematic literature search up to November 2013 was performed using 4 different
electronic databases: PubMed, Embase, Cochrane Clinical Trials, and Web of
Science. STUDY SELECTION: Inclusion criteria were as follows: (1) research
studies that included breast cancer patients who were surgically treated using
the sentinel lymph node biopsy (SLNB) technique; (2) sentinel node-negative
patients; (3) studies that investigated lymphedema as a primary or secondary
outcome; (4) data extraction for the incidence or time path of lymphedema was
possible; and (5) publication date starting from January 1, 2001. Exclusion
criteria were as follows: (1) reviews or case studies; (2) patients who had an
SLNB followed by an axillary lymph node dissection (ALND); (3) results of ALND
patients and SLNB patients not described separately; and (4) studies not written
in English. DATA EXTRACTION: After scoring the methodological quality of the
selected studies, the crude data concerning the incidence of lymphedema were
extracted. Data concerning the time points and the incidence of lymphedema were
also extracted. DATA SYNTHESIS: Twenty-eight articles were included, representing
9588 SLNB-negative patients. The overall incidence of lymphedema in patients with
sentinel node-negative breast cancer ranged from 0% to 63.4%. The studies that
have assessed lymphedema at predefined time points, instead of a mean follow-up
time, demonstrated an incidence range at 18 months
postsurgery of 3.2% to 5%, 2% to 10%, 3% to 63.4%, 6.6% to 7%, and 6.9% to 8.2%,
respectively. CONCLUSIONS: In SLNB patients, lymphedema is still a problem,
mostly occurring 6 to 12 months after surgery. Because of different assessments
and criteria, there is a wide range in incidence. Clear definitions of lymphedema
are absolutely necessary to tailor therapy.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS