The pathophysiology of lymphedema.

Abstract:

BACKGROUND:All edemas result from an imbalance between capillary filtration and tissue (lymph) drainage. This basic approach was adopted to investigate mechanisms for chronic arm edema following breast carcinoma treatment. METHODS:A review of causes of lymphedema is presented plus the traditional pathophysiology of breast carcinoma related lymphedema (postmastectomy edema; PME). A summary of recent research that explored capillary filtration as a surrogate for lymph flow in the steady state is presented. RESULTS:A reduced interstitial protein concentration (relative to plasma) argues against lymphatic obstruction. Evidence exists that total arm blood flow (in some patients) and vascular bed size are increased in PME. CONCLUSIONS:The primary insult to the axillary lymphatic system by surgery and radiotherapy presumably is the root cause of PME; however, there is strong evidence to suggest that hemodynamic factors are contributory to the chronic swelling.

journal_name

Cancer

journal_title

Cancer

authors

Mortimer PS

doi

10.1002/(sici)1097-0142(19981215)83:12b+<2798::aid

subject

Has Abstract

pub_date

1998-12-15 00:00:00

pages

2798-802

issue

12 Suppl American

eissn

0008-543X

issn

1097-0142

pii

10.1002/(SICI)1097-0142(19981215)83:12B+<2798::AID

journal_volume

83

pub_type

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