PRESENCE OF FUNCTIONAL AXILLARY LYMPH NODES AND LYMPH DRAINAGE WITHIN ARMS IN WOMEN WITH AND WITHOUT BREAST CANCER-RELATED LYMPHEDEMA

Abstract

This pilot study was designed to investigatelymphatic transport in the arms of womenafter breast cancer treatment withoutlymphedema and with mild and severe armlymphedema. Nineteen breast cancer survivors[6 without (Group 1), 6 with mild (Group 2)and 7 with severe (Group 3) lymphedema]were examined. Lymphatic transport in thearm and to axillary lymph nodes wereevaluated using quantitative radionuclidelymphscintigraphy. The radioactivity ratiobetween the operated and unoperated axillae(axillary ratio), and both lymphatic transportand tracer disappearance rates (TDR) fromthe injection sites were calculated. We foundthat axillary ratio and lymphatic transportwere significantly higher in Groups 1 and 2compared to 3 and that TDR was not affectedin any Group. Additionally, lymphscintigraphyrevealed presence of functional axillary lymphnodes within the operated axilla in womenwithout or with mild lymphedema, while inwomen with severe lymphedema, no axillarylymph nodes were visualized. We concludefrom our subjects that breast cancer survivorswho did not develop or had mild arm lymphedemahave functional lymphatic transportand lymph nodes in the axillary area on theoperated side. This suggests that efficientcollateral circulation and/or peripherallymphovenous communications has developedin these subjects which may be preventativefor the development of severe lymphedema.