• 중환자간호학회지
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• 제6권1호
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• pp.21-33
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• 2013

Purpose: The purpose of this study was to examine the relationship between lymphedema self-care management and quality of life in breast cancer patients with mastectomy and lymphedema. Methods: One hundred and eighty-six breast cancer patients with mastectomy and lymphedema (n=186) were recruited at a medical center located in Seoul. The levels of lymphedema self-care management and quality of life were measured by the scale for measurement of practice in lymphedema self-care management, European Organization for Research and Treatment of Cancer-Quality of Life Core 30 (EORTC QLQ-C30) and European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ BR23), respectively. Data were analyzed with SPSS 18.0 program. Results: There were statistically significant correlations between lymphedema self-care management and general health status/quality of life in mastectomy patients with lymphedema (r=.30, p<.001). The physical function score of cancer related function scale (r=-.15, p=.033), fatigue score of cancer related symptom scale (r=.15, p=.036), systemic side effect score of breast cancer related symptom scale (r=.45, p=.034), and upset by hair loss (r=.27, p=.004) were significantly correlated with quality of life. Conclusion: The findings suggest that these significant factors should be considered when caring for lymphedema patients.

• Archives of Plastic Surgery
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• 제49권2호
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• pp.150-157
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• 2022

Patients undergoing treatment for breast cancer who undergo an axillary dissection and require adjuvant therapies such as radiation and chemotherapy are at high risk of developing lymphedema of the associated extremity. Historically, patients with lymphedema were treated with ablative procedures aimed simply to remove excess fluid and adiposity; however, the field of lymphatic surgery employing super-microsurgery techniques has witnessed tremendous advances in a relatively short period of time. Advancements in surgical instruments, microscope magnification and optics, imaging technology, and surgeon experience have ushered in a new era of hope to treat patients suffering from breast cancer-related lymphedema (BCRL). Here we aim to present the available options for patients suffering from BCRL, and the pinnacle in reconstruction and restoration for these patients.

• 성인간호학회지
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• 제18권3호
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• pp.357-366
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• 2006

Purpose: The purpose of this study were to examine the incidence of lymphedema and to compare to physiological and psychosocial symptoms between breast cancer patients with lymphedema and without lymphedema. Method: Four hundreds fifty women with breast cancer receiving mastectomy were recruited from two out-patient breast clinics of A and S university hospitals in Seoul, Korea from October, 2004 to May, 2005. Lymphedema was defined by circumferential measurement. Differences greater than 2cm between the affected arm and normal arm were considered to be lymphedema. A descriptive design was used for this study and data was collected using a structured questionnaire. The data were analyzed using descriptive statistics and independent t-test. Results: Lymphedema developed in 112(24.9%) of the 450 subjects. Subjects with lymphedema reported more severe sensation change of arm and more depression and confusion than subjects without lymphedema. Range of motion of shoulder as a physical indicator and social support, however, were not significantly different between the two groups. Conclusion: Lymphedema is recognized as an unpleasant and uncomfortable consequence of breast cancer-related treatment. Therefore, more research is needed to evaluate the impact of lymphedema on quality of life in patients with lymphedema and the efficacy of nursing intervention.

• Clinical Pain
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• 제19권2호
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• pp.129-132
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• 2020

Fracture is uncommon cause of lymphedema. The mechanism of lymphedema progression is still unknown, but disruption of the lymphatic system during and after fracture might be involved. In contrast, breast cancer surgery is a common cause of lymphedema and is usually caused by the removal of axillary lymph nodes. Sentinel node biopsy (SNB) has been adopted in early breast cancer to reduce the risk of lymphedema. Thus, the incidence of lymphedema in SNB was lowered. However, less than 10% of SNB patients are still diagnosed with lymphedema, but it is known that it took years to diagnose. Recently, we encountered atypical lymphedema occurred after breast cancer surgery with SNB. Symptoms started earlier than usual and were more severe. Interestingly, she has a history of a proximal radial fracture on the same side of SNB. We thought there could be a relationship between the acceleration of breast cancer-related lymphedema and fracture.

• Medical Lasers
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• 제10권4호
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• pp.189-194
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• 2021

Breast cancer-related lymphedema (BCRL) is characterized by the persistent accumulation of interstitial fluid in the peripheral tissues after treatment for breast cancer. Photobiomodulation (PBM) therapy is widely used as supportive care for patients with BCRL. A search was performed in the PubMed database to find relevant articles published over the last 20 years. Randomized controlled trials that evaluated the efficacy of PBM therapy on BCRL were included. A total of 24 studies were identified through the PubMed database. Seven studies were used for the final analysis, after excluding items that did not meet the duplication and inclusion criteria. Although PBM showed some improvement in reducing arm circumference and the symptoms related to BCRL, the results of the meta-analysis did not show any significant benefit in alleviating lymphedema. Further studies are needed with the recruitment of more participants to evaluate the long-term efficacy and safety of PBM in the management of BCRL.

• Physical Therapy Rehabilitation Science
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• 제9권1호
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• pp.43-48
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• 2020

Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage (MLD) is designed to reduce lymph swelling by facilitating lymphatic drainage. This study attempted to determine the histologic changes in the skin and subcutaneous layer, and the immediate effect of MLD in decreasing lymphedema using ultrasound imaging, which is the method used most commonly to eliminate BCRL. Design: A single-group experimental study. Methods: Five subjects who were diagnosed with hemiparetic upper extremity lymphedema more than six months after breast cancer surgery participated in the study. MLD was performed for 60 minutes in the order of the thorax, breast, axilla, and upper arm of the affected side. In order to determine the effect of MLD, ultrasound imaging and limb volume were assessed. Two measurement tools were used for asessing lymphedema thickness among the pretest, posttest, and 30-minute follow-up period. Results: Significant diferences in ultrasound imaging and upper limb volume were found between the affected side and non-affected side (p<0.05). On the affected side, although ultrasound imaging showed a significant decrease after MLD (p<0.05), there were no significant difference in upper limb volume when compared to the baseline. Conclusions: In this study, a significant decrease in lymphedema by MLD was demonstrated by ultrasound imaging, which is considered to be more useful in assessing histological changes than limb volume measurements. Further research on the protocol for eliminating lymphedema will be needed.

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.339-344
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• 2015

Purpose: The purpose of this study was to determine the effects of high and low resistance exercise using an elastic band on the strength and lymphedema of upper extremity in patients with breast cancer. Methods: Seventeen female patients with breast cancer related lymphedema were randomly allocated to the high (n=9) or low (n=8) resistance exercise group. Both groups participated in the elastic band exercise program three times a week for eight weeks. For the high resistance exercise group (HR), the resistance was gradually increased, while maintaining constant intensity of exercise for the low resistance exercise group (LR). Assessments made include the upper extremity muscle strength and lymphedema before and after training. Results: After the exercise program, the HR showed significantly improved shoulder flexion and elbow flexion strength variation compared to the LR (p<0.05). Upper arm edema rate was significantly decreased in HR (p<0.05), but the difference between the two groups was not significant. Conclusion: These findings suggest that the elastic band exercise helps improve the strength and lymphedema of upper extremity in patients with breast cancer. In particular, high resistance exercise is more effective in improving muscle strength and does not exacerbate lymphedema, rather may improve upper arm edema if it is applied with a low elastic bandage or compression sleeve.

• 대한한방내과학회지
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• 제40권3호
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• pp.343-355
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• 2019

Objectives: Traditional oriental medicine is used in treating breast cancer-related lymphedema to alleviate symptoms. Upper limb lymphedema is a symptom that is frequently observed in patients with breast cancer, and it impairs their quality of life. This systematic review aimed to summarize the current available evidence to evaluate the effect of traditional oriental medicine on upper limb lymphedema in breast cancer patients. Methods: The review evaluated randomized controlled trials (RCTs) measuring the effect of herbal medicine, acupuncture, and moxibustion on upper limb lymphedema in breast cancer patients within four electronic databases. The Cochrane risk of bias (ROB) tool was used to assess the quality of the RCTs. Results: In total, 23 RCTs met the inclusion criteria. Among them, 22 studies reported that the rate of severity of lymphedema improved after treatment in the traditional treatment group using herbal medicine, acupuncture, or moxibustion better than in the conventional medicine group. The methodological quality of the RCTs was insufficient with an unclear and high ROB. Conclusions: Traditional oriental medicine may have a potential to improve lymphedema in patients with breast cancer. To confirm the clinical recommendation, further research with a rigorous study design is required to support the effects of traditional oriental medicine.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6535-6541
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• 2014

Background: To evaluate risk factors for upper extremity lymphedema due to breast cancer surgery. Materials and Methods: Clinical studies published on PubMed, Ovid, EMbase, and Cochrane Library from January 1996 to December 2012 were selected. Results: Twenty-five studies were identified, including 12,104 patients. Six risk factors related to the incidence of lymphedema after breast cancer treatment were detected: axillary lymph node dissection (OR=3.73, 95%CI 1.16 to 11.96), postoperative complications (OR=2.64, 95%CI 1.10 to 6.30), hypertension (OR=1.83, 95%CI 1.38 to 2.42), high body mass index (OR=1.80, 95%CI 1.30 to 2.49), chemotherapy (OR=1.38, 95%CI 1.07 to 1.79) and radiotherapy (OR=1.35, 95%CI 1.10 to 1.66). We found significant protective factors for lymphedema: pathologic T classification (OR=0.57, 95%CI 0.36 to 0.91) and stage (OR=0.60, 95%CI 0.39 to 0.93), while some factors, like age, number of positive lymph nodes, number of lymph node dissection, demonstrated no obvious correlation. Conclusions: Axillary lymph node dissection, postoperative complications, hypertension, body mass index, chemotherapy, radiotherapy are risk factors for lymphedema after breast cancer treatment. Attention should be paid to patients with risk factors to prevent the occurrence of lymphedema.

• 대한물리의학회지
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• 제8권2호
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• pp.153-161
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• 2013

PURPOSE: This study aimed to investigate the effect of complex theraputic exercise on visual analog scale of pain, shoulder' range of motion for middle-aged women with breast cancer related lymphedema. METHODS: The 14 middle-aged women involved voluntary in this study and then they were divided into two groups(n =7 per group). The complex exercise program was implemented over 4 weeks, 60 minutes per day, with 3 types of exercise for stimulation whereas the control group was performed a classical decongestive physiotherapy in a same day. For data analysis, the mean and standard deviation were estimated; 2 way repeated measures ANOVA was carried out. RESULTS: First, The level of VAS was significantly reduced on time, interaction effect in the group. Second, most factors of ROM were significantly increased on time, interaction effect whereas extension was not significantly increased. CONCLUSION: In conclusion, Our results showed that complex therapeutic exercise could improve or maintain VAS and ROM of shoulder joint for middle-aged women with breast cancer related lymphedema.