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그림1. 우측 상지 부종 환자로 우측 액와 림프절이 잘 관찰되고, 치료에 대한 반응이 우수하였음.

그림2. 우측 상지 부종 환자로 우측 액와 림프절이 관찰되지 않았으며, 치료에 대한 반응이 좋지 않았음.

Abstract
PURPOSE:
We evaluated the prognostic value of lymphoscintigraphy after complex decongestive therapy (CDT) in breast cancer-related secondary lymphedema.

METHODS:
Prior to CDT, 80 patients with breast cancer-related lymphedema underwent a 99mTc tin-colloid lymphoscintigram. We investigated the uptake patterns of axillary lymph nodes (LNs), main lymphatic vessels, collateral lymphatic vessels, and dermal back flow in the lymphoscintigraphy of the upper extremities. We also compared the above findings with other clinical variables between patients who respond well to CDT (responders) and those who do not (poor responders). We used Pearson's χ2 test and Fisher's exact test to compare the lymphoscintigram findings with the studied variables.

RESULTS:
There were 50 poor responders and 30 responders 1 year after CDT. There were significant differences between the two groups with regard to compliance (P < 0.05) and visualization of axillary LNs (P < 0.05). In combined results, the odds ratio was 21.33 (2.37-192.03) in the compliance and visible axillary LNs group compared to the poor compliance and invisible axillary LNs group.

CONCLUSION:
Lymphoscintigraphy of the upper extremities can be a useful tool to predict the prognosis of CDT in breast cancer-related lymphedema patients.

Author information

Kim YH1, Hwang JH2, Bae JH3, Choi JY4.
1
Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Department of Physical & Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
4
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. jynm.choi@samsung.com.