Abstract

DIAZ HERNANDEZ, Orestes L.. Análisis de los factores de riesgo en el linfedema posmastectomía. Rev Cubana Hig Epidemiol [online]. 2000, vol.38, n.2, pp.127-136. ISSN 0253-1751.

Risk factors of the post-mastectomy lymphedema were studied and analyzed in the Outpatient Department of Angiology and Vascular Surgery where 120 patients mastectomized from breast cancer, 95 of them with post-mastectomy lymphedema, and 25 cosdntrols were studied. The variables to be analyzed were divided into 2 groups: one with primary risk factors such as tumor stage, radiotherapy, type of mastectomy, surgical complications and the condition of pathological ganglia and the other with secondary risk factors like lymphangitis, spleen fibrosis, bracchial plexitis, arterial, venous and lymphatic flow and scar retraction. Of the primary risk factors, the axillary dissection reached a relative risk of 1.32 with a p < 0,05 and the rest pf tjese factprs were not considered important risks for edema formation. All the secondary risk factors had a relative risk over 3 with p < 0,05 for all the analyzed factors. The axillary dissection associated with radiotherapy may contribute to the formation of an edema due to the chronic lymphatic occlusion that occurs. Additionally, if there is an axillary vein thrombosis or an acute lymphagitis in the arm, a scar retraction takes place in the axilla, the arm becomes fibrotic, and the affected bracchial plexus hinders the movements of the upper limb, the the lymphedema may take a grotesque dimension. Careful axillary dissection to avoid affecting nerves and vessels and radiotherapy with adequate dosage may reduce the possibilities of lymphatic edema. We strongly recommend the strict control of the risk factors that have been analyzed and studied in this paper. 

Keywords : LYMPHEDEMA [radiotherapy]; BREAST NEOPLASMS [surgery]; MASTECTOMY [mortality]; LIFE EXPECTANCY; RISK FACTORS; INTRAOPERATIVE COMPLICATIONS.

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