Objective. To develop a technique for intraoperative prevention of postmastectomy lymphedema in patients with locally advanced breast cancer.
Materials and methods. The study included 176 patients with IIIb–IIIc stages of breast cancer (90 of the main group and 86 of the control group). The groups were comparable in terms of the main clinical and biological parameters.
Results. A surgical technique of lymph node dissection has been developed for the prevention of postmastectomy lymphedema in patients with locally advanced breast cancer. Its application didn’t lead to an increase of surgical intervention duration (in the control group — 98.1±3.76 minutes, in the main group — 98.1±2.18 minutes (p=0.221)), it reduced the duration of postoperative lymphorrhea (in the control group — 12.2±0.6 days, in the main group — 10.1±0.5 days, р=0.018) as well as the terms of hospitalization of patients (in the control group — 22.0±0.64 days, in the main group — 19.9± 0.63 days, p=0.025).
21 cases of secondary post-mastectomy edema were revealed in the main group (23.3±4.5 %) and 36 cases — in the control group (41.9±5.3 %) (p=0.009). The lymphedema of I and II degree of severity only was registered in patients included in the study. In the control group, lymphedema of the upper limb of II degree (55.6±8.3 %) was recorded more frequently (p=0.049) than in the main group — 28.6±9.9 %. There was also an improvement in the results of the overall
5-year survival in patients having been undergone the developed surgical technique (control group — 60.3±5.4 %, main — 74.3±4.7 %), (p=0.047).
Conclusion. Thus, the technique for intraoperative prevention of postmastectomy lymphedema in patients with locally advanced breast cancer has been developed, it also reduced the incidence and severity of lymphedema as well as improved patient survival.Ключевые слова:
Автор(ы): S. A. Krasny, N. A. Kаzlouskaya, N. A. Artemova