On Examination of Dynamic Function of Lymphatic System in Upper Limb on the Affected Side before and after Surgery of Breast Cancer (1)

• Published in: Japanese Journal of National Medical Services Vol. 42; no. 12; pp. 1119 - 1126
• Main Authors: KITAJIMA, Toyozo, UEDA, Toshisada, NAKAJIMA, Masahiko, NANBA, Toru, KUROTA, Ryohei, HAYAMA, Norihiro, OKUMURA, Kojiro, NISHIMURA, Akira, ICHIKAWA, Mitsuaki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1988
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.42.1119

The dynamic function of the lymphatic system in the upper limb was examined by 99mTc-HSA and the changes in lymph flows before and after surgery of breast cancer were examined. There were various types of lymphatic drainage system even in the normal cases, and these were classified into type I (subtypes a, b, c, and d) and type II (subtypes a, b, c, d, e, and f). Type j decreased and type 11 increased after surgery of breast cancer. Postoperative edema was hardly observed in type j . When comparison was made between modified mastectomy and standard (extended) mastectomy, edema developed more frequently in the latter, and cases more than 3 years after operation showed a stronger tendency to have edema. Postoperative edema was hardly observed in cases where a lymph flow around the cephalic vein was observed before or after surgery. Even in the normal cases, some showed stagnation of lymphatic flow around the subclavian region, and the diagnosis of metastasized lymph node by this method of examination was difficult. Although saving life is the first thing to consider in the treatment of cancer, complete removal of the axillary lymph nodes in cases of early breast cancer is controversial. Particularly, when removal of the adipose tissue on the cranial side of the subclavian artery and vein, around the cephalic vein and near the venous angle is performed, due care must be exercised, since this may cause postoperative edema.