Yıl: 2014 Cilt: 10 Sayı: 1 Sayfa Aralığı: 6 - 14 Metin Dili: Türkçe

Lymphedema after breast cancer and its treatment

Öz:
Lenfödem (LÖ), yetersiz lenfatik drenaj sebebiyle proteinden zengin sıvı- nın interstisyel aralıkta anormal birikimi sonucu oluşan kronik ve ilerleyicibir durumdur. Meme kanseri tedavisinin en önemli komplikasyonlarındanbiri de; kol, el ve gövdede gelişebilecek LÖdür. Meme kanseri ile ilişkili LÖ görülme insidansının %6-30 arasında olduğu belirtilmektedir. LÖnünen önemli risk faktörleri; aksiller cerrahinin tipi ve cerrahi sonrası hastanınaldığı kemoterapi ve/veya radyoterapi miktarıdır. Son yapılan çalışmalarmeme kanseri tedavisinde; aksiller lenf nodu diseksiyonunun yerini, senti- nel lenf nodu biopsisinin aldığını ortaya koymuştur. LÖ tanısı konulurken ödemin tek taraflı veya asimetrik olması, cilt renginin normal olması, Stem-mer işaretinin pozitif olması, ödemin yoğunluğunun artmış olması ve eks-tremitenin ağrısız olması gibi klinik özelliklere dikkat edilir. LÖ tanısı ko- nulduktan sonra hastanın değerlendirilmesi öykü, fiziksel testler, metastaz ve derin ven trombozu riskinin sorgulanmasını kapsar. Hastalığın tedavisi ise medikal tedavi, cerrahi tedavi ve fizyoterapi başlıkları altında toplana-bilir. Kompleks Dekonjestif Terapi (KDT) LÖ tedavisi için altın standart olarak kabul edilmektedir. KDT konsepti dört temel bileşen (manuel lenfdrenajı, cilt bakımı, kompresyon tedavisi ve terapatik egzersiz) ve iki fazdan oluşmaktadır. Sonuçta unutulmaması ve öğretilmesi gereken LÖnün hayat boyu bakım gerektiren kronik bir rahatsızlık olduğudur. Bu derlemede LÖ gelişimi için; insidans, risk faktörleri, bu faktörlerin önlenmesine yönelikyaklaşımlar, değerlendirme yöntemleri ve tedavi seçenekleri tartışılmaktadır.
Anahtar Kelime:

Meme kanseri ile ilişkili lenfödem ve tedavisi

Öz:
Lymphedema (LE) is a chronic and progressive condition which is an ab-normal retention of protein-rich fluid in the interstitial space because ofinadequate lymphatic drainage. One of the most important complicationsof breast surgery is LE that can occur in the arm, hand and trunk. The inci-dence of breast cancer associated LE is reported 6-30%. The most importantrisk factors of LE are the type of axillary surgery and amount of chemother-apy and/or radiotherapy exposure after surgery. Recent studies showed thatsentinel lymph node biopsy replaces axillary lymph node dissection in breastcancer treatment. For diagnosis of LE; clinical properties such as the unilat-eral or asymmetric character of edema, normal skin color, positive Stemmersign, increased density of edema and extremity pain should be considered.After diagnosis, assessment of the patient includes obtaining informationabout anamnesis, physical tests, metastasis and risk of deep vein thrombosis.Treatment of the condition can be summarized under the topic of medi-cal treatment, surgery and physiotherapy. Complex Decongestive Therapy(CDT) is accepted as the golden standard for LE treatment. CDT conceptconsists of four basic components (manual lymph drainage, skin care, com-pression treatment, therapeutic exercise) and two phases. Finally it shouldnot be forgotten and should be learned that LE is a chronic condition thatneeds lifelong care. In this review; incidence, risk factors, approaches forprotection of this factors, assessment methods and therapy options for LEare have been discussed.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
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APA BAKAR Y, BERDİCİ B, ŞAHİN N, PALA Ö (2014). Lymphedema after breast cancer and its treatment. Meme Sağlığı Dergisi, 10(1), 6 - 14.
Chicago BAKAR YEŞİM,BERDİCİ Burcu,ŞAHİN Nazlı,PALA ÖMER OSMAN Lymphedema after breast cancer and its treatment. Meme Sağlığı Dergisi 10, no.1 (2014): 6 - 14.
MLA BAKAR YEŞİM,BERDİCİ Burcu,ŞAHİN Nazlı,PALA ÖMER OSMAN Lymphedema after breast cancer and its treatment. Meme Sağlığı Dergisi, vol.10, no.1, 2014, ss.6 - 14.
AMA BAKAR Y,BERDİCİ B,ŞAHİN N,PALA Ö Lymphedema after breast cancer and its treatment. Meme Sağlığı Dergisi. 2014; 10(1): 6 - 14.
Vancouver BAKAR Y,BERDİCİ B,ŞAHİN N,PALA Ö Lymphedema after breast cancer and its treatment. Meme Sağlığı Dergisi. 2014; 10(1): 6 - 14.
IEEE BAKAR Y,BERDİCİ B,ŞAHİN N,PALA Ö "Lymphedema after breast cancer and its treatment." Meme Sağlığı Dergisi, 10, ss.6 - 14, 2014.
ISNAD BAKAR, YEŞİM vd. "Lymphedema after breast cancer and its treatment". Meme Sağlığı Dergisi 10/1 (2014), 6-14.