Lymphoedema: Difference between revisions
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== Prevalence == | == Prevalence == | ||
The incidence of lymphedema is unknown because it goes unreported. When looking at the primary cause 15% of lymphedema cases are reported at birth, 75% during adolescence with a ratio of 4:1 females to males, 10-20% after the age of 35, with 2 % in other syndromes. Secondary causes are just an approximation of the incidences of filariasis, an infection caused by mosquitoes, because it spans across the globe. There was an estimate of 420 million people were exposed to filariasis in Africa in the year 2000 and the WHO estimated 700,000 incidences in the Americas. There are around 3 million cases in the US with 30% of those are cases secondary to breast cancer.<sup>2</sup> One study looked at 300 patients with breast cancer a year later the prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema.<sup>7</sup> | |||
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== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
Revision as of 22:56, 31 March 2011
Original Editors - Emily Clark from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
Lymphatic obstruction is a blockage of a lymph vessel that drains fluid and
immune cells from tissue throughout the body.1 An obstruction could cause an
impaired contraction of the collecting lymphatics, causing lymphedema which is a
build up of lymph fluid in the soft tissue.2
Lymphedema has been classified into grades of severity by the International Society of Lymphology:
• Stage 0 (Latent lymphedema)- Lymph transport capacity is reduced, no clinical edema is present.
• Stage1 - Reversible pitting edema with elevation; Increasing edema with increase in activity, heat, and humidity.
• Stage 2 - Accumulation of protein-rich nonpitting edema with connective scar tissue. Irreversible ; does not resolve overnight; increasingly more difficult to pit.Clinical fibrosis is present.Skin changes present in severe stage 2.
• Stage 3(Lymphostatic Elephantiasis)-Accumulation of protein-rich edema with significant increase in connective and in scar tissue. Severe non-pitting fibrosis edema.Strophic changes (hardening of dermal tissue, skin folds, skin papillomas, and hyperkeratosis)2,3,5
Lymphedema can be divided into 2 categories primary/ idiopathic and secondary/ acquired. The primary cause of lymphedema happens due to a malformation of the lymph vessels. Secondary lymphedema is damage that has been done to normal healthy lymph vessels.2
Prevalence[edit | edit source]
The incidence of lymphedema is unknown because it goes unreported. When looking at the primary cause 15% of lymphedema cases are reported at birth, 75% during adolescence with a ratio of 4:1 females to males, 10-20% after the age of 35, with 2 % in other syndromes. Secondary causes are just an approximation of the incidences of filariasis, an infection caused by mosquitoes, because it spans across the globe. There was an estimate of 420 million people were exposed to filariasis in Africa in the year 2000 and the WHO estimated 700,000 incidences in the Americas. There are around 3 million cases in the US with 30% of those are cases secondary to breast cancer.2 One study looked at 300 patients with breast cancer a year later the prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema.7
Characteristics/Clinical Presentation[edit | edit source]
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