| Hand surgery after axillary lymph node clearance for breast cancer: contra-indication to surgery? | |
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MedLine Citation:
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PMID: 20587171 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Breast cancer patients who have had prior axillary lymph node clearance (ALNC) can present with ipsilateral hand conditions that could easily be treated with surgical intervention. These patients are often advised to avoid interventional procedures due to risks of complications such as lymphoedema, infection and cellulitis. SUBJECTS AND METHODS: Between April and June 2009, we conducted an online survey of hand surgeons, breast surgeons and breast-care nurses to obtain their views on hand surgery after ipsilateral axillary lymph node clearance. RESULTS: The majority of hand surgeons (58%) felt there was no contra-indication to surgery in a breast cancer patient with prior ipsilateral ALNC compared to just 30% of breast surgeons and 10% of breast-care nurses. The majority of breast surgeons and breast-care nurses (70% and 89%, respectively) felt that hand surgery was a relative contra-indication compared to just 41% of hand surgeons. Postoperative lymphoedema was the commonest cited reason for avoiding surgery. The majority of hand surgeons (79%) and nearly two-thirds of breast surgeons (57%) would use a tourniquet during surgery if it was normal practice. CONCLUSIONS: A review of the published literature does not support the notion that these patients experience increased complications; therefore, we recommend the advice given to breast cancer patients regarding ipsilateral surgery be re-evaluated. |
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Authors:
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Dean Fulford; Sam Dalal; John Winstanley; Mike J Hayton |
Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2010-06-28 |
Journal Detail:
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Title: Annals of the Royal College of Surgeons of England Volume: 92 ISSN: 1478-7083 ISO Abbreviation: Ann R Coll Surg Engl Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-01 Completed Date: 2010-10-21 Revised Date: 2012-01-04 |
Medline Journal Info:
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Nlm Unique ID: 7506860 Medline TA: Ann R Coll Surg Engl Country: England |
Other Details:
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Languages: eng Pagination: 573-6 Citation Subset: IM |
Affiliation:
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Department of Orthopaedics, Royal Bolton Hospital, Farnworth, UK. drdean@doctors.org.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Attitude of Health Personnel Axilla Breast Neoplasms* Cellulitis / etiology Female Hand / surgery* Humans Lymph Node Excision / adverse effects*, methods Lymphatic Metastasis Lymphedema / etiology Surgical Procedures, Elective / contraindications Surgical Wound Infection / etiology Tourniquets / utilization |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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