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Prise en charge du lymphœdéme

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Aider á vivre aprés un cancer

Part of the book series: Oncologie pratique ((ONCOLPRAT))

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Résumé

Le lymphœdéme du membre supérieur aprés traitement du cancer du sein est une complication dont la fréquence est estimée actuellement entre 15 % et 28 % aprés curage axillaire et entre 2,5 % et 3,5 % aprés technique du ganglion sentinelle (1–4). Les principaux facteurs de risque de développement d’un lymphœdéme sont le nombre de ganglions enlevés lors du curage axillaire, la radiothérapie, en particulier sur les aires ganglionnaires axillaires, la mammectomie (versus la tumorectomie) et la surcharge pondérale (5). L’évolution spontanée du lymphœdéme se fait vers l’aggravation progressive avec l’apparition d’un épaississement et d’une «fibrose» cutanés irréversibles, de complications esthétiques, psychologiques (6) et infectieuses (érysipéles). Les indications de traitement ne sont pas clairement défi nies, mais il est important de traiter les lymphœdémes afi n d’éviter ces complications et d’espérer ainsi améliorer la qualité de vie des femmes. Les critéres de traitement sont le volume du lymphœdéme, mais également la demande de la patiente. Le traitement du lymphœdéme est symptomatique et a fait l’objet de plusieurs consensus et recommandations (7–9) ainsi que d’une revue Cochrane reprenant toutes les études de bonnes qualités méthodologiques concernant les traitements physiques (10).

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  1. Unité de lymphologie, Hôpital Cognacq-Jay, 15, rue Eugéne-Millon, 75015, Paris

    Stéphane Vignes

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  1. Stéphane Vignes
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Vignes, S. (2010). Prise en charge du lymphœdéme. In: Aider á vivre aprés un cancer. Oncologie pratique. Springer, Paris. https://doi.org/10.1007/978-2-287-79501-5_3

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  • DOI: https://doi.org/10.1007/978-2-287-79501-5_3

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-79500-8

  • Online ISBN: 978-2-287-79501-5

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