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Breast Surgical Techniques and Interdisciplinary Management pp 1015–1027Cite as

Managing Breast Cancer-Associated Lymphedema

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Abstract

Lymphedema is a chronic debilitating disease that is frequently misdiagnosed, treated too late, or not treated at all. When this problem occurs as a consequence of prior breast cancer therapy, it represents the most extensively studied cause of acquired lymphatic vascular insufficiency. It is reasonable to surmise, therefore, that among the cancer-related lymphedemas, the breast cancer-associated form is the one most commonly encountered. The obliteration of previously normal lymphatic channels is the hallmark of the acquired form of lymphedema. In the context of cancer therapeutics, lymphedema is most commonly associated with surgical excision of lymph nodes, or their irradiation. For breast cancer survivors, axillary lymph node dissection and adjuvant radiation therapy are both predisposing factors, particularly when the axilla is included in the radiation field. This chapter reviews the incidence, clinical findings, potential causes, and treatment options for patients with lymphedema.

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References

  1. Rockson SG. Lymphedema. Curr Treat Options Cardiovasc Med. 2006;8:129–36.

    Article  PubMed  Google Scholar 

  2. Rockson SG. Addressing the unmet needs in lymphedema risk management. Lymphat Res Biol. 2006;4:42–6.

    Article  PubMed  Google Scholar 

  3. Shaw JH, Rumball EM. Complications and local recurrence following lymphadenectomy. Br J Surg. 1990;77:760–4.

    Article  PubMed  CAS  Google Scholar 

  4. Rockson SG. Precipitating factors in lymphedema: myths and realities. Cancer. 1998;83:2814–6.

    Article  PubMed  CAS  Google Scholar 

  5. Halsted WS. The swelling of the arm after operation for cancer of the breast, elephantiasis chirurgica, its causes and prevention. Bull J Hopk Hosp. 1921;32:309–13.

    Google Scholar 

  6. Aitken RJ, Gaze MN, Rodger A, Chetty U, Forrest AP. Arm morbidity within a trial of mastectomy and either nodal sample with selective radiotherapy or axillary clearance. Br J Surg. 1989;76:568–71.

    Article  PubMed  CAS  Google Scholar 

  7. Kissin M, Querci della Rovere G, Easton D, Westbury G. Risk of lymphedema following the treatment of breast cancer. Br J Surg. 1986;73:580–4.

    Article  PubMed  CAS  Google Scholar 

  8. Badr el Din A, Coibion M, Guenier C, Nogaret JM, Lorent I, Van Houtte P, Tueni E, Mattheiem W. Local postoperative morbidity following pre-operative irradiation in locally advanced breast cancer. Eur J Surg Oncol. 1989;15:486–9.

    PubMed  CAS  Google Scholar 

  9. Hoe A, Iven D, Royle G, et al. Incidence of arm swelling following axillary clearance for breast cancer. Br J Surg. 1992;79:261–2.

    Article  PubMed  CAS  Google Scholar 

  10. Segerstrom K, Bjerle P, Graffman S, Nystrom A. Factors that influence the incidence of ­brachial oedema after treatment of breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1992;26:223–7.

    Article  PubMed  CAS  Google Scholar 

  11. Mortimer P, Bates D, Brassington H, Stanton A, Strachan D, Levick J. The prevalence of arm oedema following treatment for breast cancer. Q J Med. 1996;89:377–80.

    Article  Google Scholar 

  12. Schunemann H, Willich N. Lymphoedema of the arm after primary treatment of breast cancer. Anticancer Res. 1998;18:2235–6.

    PubMed  CAS  Google Scholar 

  13. Moffatt CJ, Franks PJ, Doherty DC, Williams AF, Badger C, Jeffs E, et al. Lymphoedema: an underestimated health problem. QJM. 2003;96:731–8.

    Article  PubMed  CAS  Google Scholar 

  14. Petrek JA, Heelan MC. Incidence of breast carcinoma-related lymphedema. Cancer. 1998; 83:2776–81.

    Article  PubMed  CAS  Google Scholar 

  15. Berlin E, Gjores JE, Ivarsson C, Palmqvist I, Thagg G, Thulesius O. Postmastectomy lymphoedema. Treatment and a five-year follow-up study. Int Angiol. 1999;18:294–8.

    PubMed  CAS  Google Scholar 

  16. Hojris I, Andersen J, Overgaard M, Overgaard J. Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone. Acta Oncol. 2000;39:355–72.

    Article  PubMed  CAS  Google Scholar 

  17. Tengrup I, Tennvall-Nittby L, Christiansson I, Laurin M. Arm morbidity after breast-­conserving therapy for breast cancer. Acta Oncol. 2000;39:393–7.

    Article  PubMed  CAS  Google Scholar 

  18. Herd-Smith A, Russo A, Muraca MG, Del Turco MR, Cardona G. Prognostic factors for lymphedema after primary treatment of breast carcinoma. Cancer. 2001;92:1783–7.

    Article  PubMed  CAS  Google Scholar 

  19. Petrek JA, Senie RT, Peters M, Rosen PP. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001;92:1368–77.

    Article  PubMed  CAS  Google Scholar 

  20. Sener SF, Winchester DJ, Martz CH, Feldman JL, Cavanaugh JA, Winchester DP, et al. Lymphedema after sentinel lymphadenectomy for breast carcinoma. Cancer. 2001; 92:748–52.

    Article  PubMed  CAS  Google Scholar 

  21. Kwan W, Jackson J, Weir L, Dingee C, McGregor G, Olivotto I. Chronic arm morbidity after curative breast cancer treatment: Prevalence and impact on quality of life. J Clin Oncol. 2002;20:4242–8.

    Article  PubMed  Google Scholar 

  22. Meric F, Buchholz TA, Mirza NQ, Vlastos G, Ames FC, Ross MI, et al. Long-term complications associated with breast-conservation surgery and radiotherapy. Ann Surg Oncol. 2002;9:543–9.

    Article  PubMed  Google Scholar 

  23. Nagel PH, Bruggink ED, Wobbes T, Strobbe LJ. Arm morbidity after complete axillary lymph node dissection for breast cancer. Acta Chir Belg. 2003;103:212–6.

    PubMed  CAS  Google Scholar 

  24. Querci della Rovere G, Ahmad I, Singh P, Ashley S, Daniels IR, Mortimer P. An audit of the incidence of arm lymphoedema after prophylactic level I/II axillary dissection without division of the pectoralis minor muscle. Ann R Coll Surg Engl. 2003;85:158–61.

    Article  CAS  Google Scholar 

  25. Pezner RD, Patterson MP, Hill LR, Lipsett JA, Desai KR, Vora N, et al. Arm lymphedema in patients treated conservatively for breast cancer: relationship to patient age and axillary node dissection technique. Int J Radiat Oncol Biol Phys. 1986;12:2079–83.

    Article  PubMed  CAS  Google Scholar 

  26. Rampaul RS, Mullinger K, Macmillan RD, Cid J, Holmes S, Morgan DA, et al. Incidence of clinically significant lymphoedema as a complication following surgery for primary operable breast cancer. Eur J Cancer. 2003;39:2165–7.

    Article  PubMed  CAS  Google Scholar 

  27. Coen JJ, Taghian AG, Kachnic LA, Assaad SI, Powell SN. Risk of lymphedema after regional nodal irradiation with breast conservation therapy. Int J Radiat Oncol Biol Phys. 2003; 55:1209–15.

    Article  PubMed  Google Scholar 

  28. Toledano A, Garaud P, Serin D, Fourquet A, Bosset JF, Breteau N, et al. Concurrent administration of adjuvant chemotherapy and radiotherapy after breast-conserving surgery enhances late toxicities: long-term results of the ARCOSEIN multicenter randomized study. Int J Radiat Oncol Biol Phys. 2006;65:324–32.

    Article  PubMed  CAS  Google Scholar 

  29. Szuba A, Rockson S. Lymphedema: anatomy, physiology and pathogenesis. Vasc Med. 1997;2:321–6.

    PubMed  CAS  Google Scholar 

  30. Kornblith AB, Herndon 2nd JE, Weiss RB, Zhang C, Zuckerman EL, Rosenberg S, et al. Long-term adjustment of survivors of early-stage breast carcinoma, 20 years after adjuvant chemotherapy. Cancer. 2003;98:679–89.

    Article  PubMed  Google Scholar 

  31. Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98:599–609.

    Article  PubMed  Google Scholar 

  32. Wilke LG, McCall LM, Posther KE, Whitworth PW, Reintgen DS, Leitch AM, et al. Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 2006;13:491–500.

    Article  PubMed  Google Scholar 

  33. Olszewski WL. Pathophysiological and clinical observations of obstructive lymphedema of the limbs. In: Clodius L, editor. Lymphedema. Stuttgart: Georg Thieme; 1977. p. 79–102.

    Google Scholar 

  34. Reed RK, Laurent TC, Taylor AE. Hyaluronian in prenodal lymph from skin: changes with lymph flow. Am J Physiol. 1990;259:H1097–100.

    PubMed  CAS  Google Scholar 

  35. Tabibiazar R, Cheung L, Han J, Swanson J, Beilhack A, An A, et al. Inflammatory manifestations of experimental lymphatic insufficiency. PLoS Med. 2006;3:e254.

    Article  PubMed  Google Scholar 

  36. Piller NB. Lymphedema, macrophages and benzopyrones. Lymphology. 1980;13:109–19.

    PubMed  CAS  Google Scholar 

  37. Piller NB. Macrophage and tissue changes in the developmental phases of secondary lymphoedema and during conservative therapy with benzopyrone. Arch Histol Cytol. 1990;53:209–18.

    Article  PubMed  Google Scholar 

  38. Schirger A, Harrison EG, Janes JM. Idiopathic lymphedema. Review of 131 cases. JAMA. 1962;182:124–32.

    Article  Google Scholar 

  39. Ryan T, de Berker D. The interstitium, the connective tissue environment of the lymphatic, and angiogenesis in human skin. Clin Dermatol. 1995;13:451–8.

    Article  PubMed  CAS  Google Scholar 

  40. Erickson V, Pearson M, Ganz P, Adams J, Kahn K. Arm Edema in Breast Cancer Patients. J Natl Cancer Inst. 2001;93:96–20101.

    Article  PubMed  CAS  Google Scholar 

  41. Mallon E, Powell S, Mortimer P, Ryan TJ. Evidence for altered cell-mediated immunity in postmastectomy lymphoedema. Br J Dermatol. 1997;137:928–33.

    Article  PubMed  CAS  Google Scholar 

  42. Simon MS, Cody RL. Cellulitis after axillary lymph node dissection for carcinoma of the breast. Am J Med. 1992;93:543–8.

    Article  PubMed  CAS  Google Scholar 

  43. Gregl A, Pavic S, Pavic Z, Schauer A, Wilke C, Zinn H. Stewart-Treves syndrome of the edematous arm following breast cancer operation. Zeitschrift fur Lymphologie. J Lymphol. 1988;12:66–83.

    CAS  Google Scholar 

  44. Dargent JL, Lespagnard L, Feoli F, Debusscher L, Greuse M, Bron D. De novo CD5-positive diffuse large B-cell lymphoma of the skin arising in chronic limb lymphedema. Leuk Lymphoma. 2005;46:775–80.

    Article  PubMed  Google Scholar 

  45. Gonzalez-Vela MC, Gonzalez-Lopez MA, Val-Bernal JF, Fernandez-Llaca H. Cutaneous diffuse large B-cell lymphoma of the leg associated with chronic lymphedema. Int J Dermatol. 2008;47:174–7.

    Article  PubMed  Google Scholar 

  46. Bartal AH, Pinsky CM. Malignant melanoma appearing in a post-mastectomy lymphedematous arm: a novel association of double primary tumors. J Surg Oncol. 1985;30:16–8.

    Article  PubMed  CAS  Google Scholar 

  47. Lister RK, Black MM, Calonje E, Burnand KG. Squamous cell carcinoma arising in chronic lymphoedema. Br J Dermatol. 1997;136:384–7.

    Article  PubMed  CAS  Google Scholar 

  48. Ruocco V, Astarita C, Guerrera V, Lo Schiavo A, Moscariello CG, Satriano RA, et al. Kaposi’s sarcoma on a lymphedematous immunocompromised limb. Int J Dermatol. 1984;23:56–60.

    Article  PubMed  CAS  Google Scholar 

  49. Rockson SG, Miller LT, Senie R, Brennan MJ, Casley-Smith JR, Foldi E, et al. American Cancer Society Lymphedema Workshop. Workgroup III: diagnosis and management of lymphedema. Cancer. 1998;83:2882–5.

    Article  PubMed  CAS  Google Scholar 

  50. Stemmer R. A clinical symptom for the early and differential diagnosis of lymphedema. Vasa. 1976;5:261–2.

    PubMed  CAS  Google Scholar 

  51. Pain SJ, Purushotham AD, Barber RW, Ballinger JR, Solanki CK, Mortimer PS, et al. Variation in lymphatic function may predispose to development of breast cancer-related lymphoedema. Eur J Surg Oncol. 2004;30:508–14.

    Article  PubMed  CAS  Google Scholar 

  52. Szuba A, Sirsikar S, Strauss H, Rockson S. Quantitative radionuclide lymphoscintigraphy predicts outcome of manual lymphatic therapy in breast cancer-related lymphedema of the upper extremity. Nucl Med Commun. 2002;23(12):201071–5.

    Article  Google Scholar 

  53. Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med. 2003;44:43–57.

    PubMed  Google Scholar 

  54. Ter SE, Alavi A, Kim CK, Merli G. Lymphoscintigraphy. A reliable test for the diagnosis of lymphedema. Clin Nucl Med. 1993;18:646–54.

    Article  PubMed  CAS  Google Scholar 

  55. Witte CL, Witte MH. Diagnostic and interventional imaging of lymphatic disorders. Int Angiol. 1999;18:25–30.

    PubMed  CAS  Google Scholar 

  56. Williams WH, Witte CL, Witte MH, McNeill GC. Radionuclide lymphangioscintigraphy in the evaluation of peripheral lymphedema. Clin Nucl Med. 2000;25:451–64.

    Article  PubMed  CAS  Google Scholar 

  57. Vaughan BF. CT of swollen legs. Clin Radiol. 1990;41:24–30.

    Article  PubMed  CAS  Google Scholar 

  58. Dimakakos PB, Stefanopoulos T, Antoniades P, Antoniou A, Gouliamos A, Rizos D. MRI and ultrasonographic findings in the investigation of lymphedema and lipedema. Int Surg. 1997;82:42010–6.

    Google Scholar 

  59. Matsushima S, Ichiba N, Hayashi D, Fukuda K. Nonenhanced magnetic resonance lymphoductography: visualization of lymphatic system of the trunk on 3-dimensional heavily T2-weighted image with 2-dimensional prospective acquisition and correction. J Comput Assist Tomogr. 2007;31:299–302.

    Article  PubMed  Google Scholar 

  60. Lohrmann C, Foeldi E, Bartholomae JP, Langer M. Gadoteridol for MR imaging of lymphatic vessels in lymphoedematous patients: initial experience after intracutaneous injection. Br J Radiol. 2007;80:569–73.

    Article  PubMed  CAS  Google Scholar 

  61. Cornish B. Bioimpedance analysis: scientific background. Lymphat Res Biol. 2006;4:47–50.

    Article  PubMed  Google Scholar 

  62. Ward LC. Bioelectrical impedance analysis: proven utility in lymphedema risk assessment and therapeutic monitoring. Lymphat Res Biol. 2006;4:51–6.

    Article  PubMed  Google Scholar 

  63. Foeldi E, Foeldi M, Weissleder H. Conservative treatment of lymphedema of the limbs. Angiology. 1985;36:171–80.

    Article  Google Scholar 

  64. Foeldi M. Treatment of lymphedema [editorial]. Lymphology. 1994;27:1–5.

    Google Scholar 

  65. Kubik S. The role of the lateral upper arm bundle and the lymphatic watersheds in the formation of collateral pathways in lymphedema. Acta Biologica Academiae Scientiarum Hungaricae. 1980;31:191–200.

    PubMed  CAS  Google Scholar 

  66. Ko DS, Lerner R, Klose G, Cosimi AB. Effective treatment of lymphedema of the extremities. Arch Surg. 1998;133:452–8.

    Article  PubMed  CAS  Google Scholar 

  67. Szuba A, Cooke JP, Yousuf S, Rockson SG. Decongestive lymphatic therapy for patients with cancer-related or primary lymphedema. Am J Med. 2000;109:296–300.

    Article  PubMed  CAS  Google Scholar 

  68. Szuba A, Achalu R, Rockson SG. Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema. A randomized, prospective study of a role for adjunctive intermittent pneumatic compression. Cancer. 2002;95:2260–7.

    Article  PubMed  Google Scholar 

  69. Wilburn O, Wilburn P, Rockson SG. A pilot, prospective evaluation of a novel alternative for maintenance therapy of breast cancer-associated lymphedema [ISRCTN76522412]. BMC Cancer. 2006;6:84.

    Article  PubMed  Google Scholar 

  70. Piller NB, Thelander A. Treatment of chronic postmastectomy lymphedema with low level laser therapy: a 2.5 year follow-up. Lymphology. 1998;31:74–86.

    PubMed  CAS  Google Scholar 

  71. Campisi C, Boccardo F, Tacchella M. Use of thermotherapy in management of lymphedema: clinical observations. Int J Angiol. 1999;8:73–5.

    Article  PubMed  Google Scholar 

  72. Carati CJ, Anderson SN, Gannon BJ, Piller NB. Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer. 2003;98:201014–22.

    Article  Google Scholar 

  73. Casley-Smith JR, Morgan RG, Piller NB. Treatment of lymphedema of the arms and legs with 5, 6-benzo-[a]-pyrone. N Engl J Med. 1993;329:201058–63.

    Article  Google Scholar 

  74. Badger C, Preston N, Seers K, Mortimer P. Benzo-pyrones for reducing and controlling lymphoedema of the limbs. Cochrane Database Syst Rev. 2004;(2):CD003140.

    Google Scholar 

  75. Bruns F, Micke O, Bremer M. Current status of selenium and other treatments for secondary lymphedema. J Support Oncol. 2003;1:121–30.

    PubMed  CAS  Google Scholar 

  76. Brorson H, Ohlin K, Olsson G, Langstrom G, Wiklund I, Svensson H. Quality of life following liposuction and conservative treatment of arm lymphedema. Lymphology. 2006;39:8–25.

    PubMed  CAS  Google Scholar 

  77. Brorson H, Ohlin K, Olsson G, Nilsson M. Adipose tissue dominates chronic arm lymphedema following breast cancer: an analysis using volume rendered CT images. Lymphat Res Biol. 2006;4:199–210.

    Article  PubMed  Google Scholar 

  78. Brorson H, Svensson H. Complete reduction of lymphoedema of the arm by liposuction after breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1997;31:137–43.

    Article  PubMed  CAS  Google Scholar 

  79. Brorson H, Svensson H. Liposuction combined with controlled compression therapy reduces arm lymphedema more effectively than controlled compression therapy alone. Plast Reconstr Surg. 1998;102:1058–67; discussion 1068.

    PubMed  CAS  Google Scholar 

  80. Rockson SG. Bioimpedance analysis in the assessment of lymphoedema diagnosis and management. J Lymphoedema. 2007;2:44–8.

    Google Scholar 

  81. Nakamura K, Rockson SG. Biomarkers of lymphatic function and disease: state of the art and future directions. Mol Diagn Ther. 2007;2010:227–38.

    Article  Google Scholar 

  82. Rockson SG. The future development of lymphatic research and biology: what is needed. Lymphat Res Biol. 2007;5:217–18.

    Article  Google Scholar 

  83. An A, Rockson SG. The potential for molecular treatment strategies in lymphatic disease. Lymphat Res Biol. 2004;2:173–81.

    Article  PubMed  CAS  Google Scholar 

  84. Shin WS, Rockson SG. Animal models for the molecular and mechanistic study of lymphatic biology and disease. Ann NY Acad Sci. 2008;201031:50–74.

    Article  Google Scholar 

  85. Karkkainen MJ, Haiko P, Sainio K, Partanen J, Taipale J, Petrova TV, et al. Vascular endothelial growth factor C is required for sprouting of the first lymphatic vessels from embryonic veins. Nat Immunol. 2004;5:74–80.

    Article  PubMed  CAS  Google Scholar 

  86. Veikkola T, Jussila L, Makinen T, Karpanen T, Jeltsch M, Petrova TV, et al. Signalling via vascular endothelial growth factor receptor-3 is sufficient for lymphangiogenesis in transgenic mice. Embo J. 2001;20:1223–31.

    Article  PubMed  CAS  Google Scholar 

  87. Makinen T, Veikkola T, Mustjoki S, Karpanen T, Catimel B, Nice EC, et al. Isolated ­lymphatic endothelial cells transduce growth, survival and migratory signals via the VEGF-C/D receptor VEGFR-3. Embo J. 2001;20:4762–73.

    Article  PubMed  CAS  Google Scholar 

  88. Cheung L, Han J, Beilhack A, Joshi S, Wilburn P, Dua A, et al. An experimental model for the study of lymphedema and its response to therapeutic lymphangiogenesis. BioDrugs. 2006;20:363–70.

    Article  PubMed  Google Scholar 

  89. Szuba A, Skobe M, Karkkainen M, Shin W, Beynet D, Rockson N, et al. Therapeutic lymphangiogenesis with human recombinant VEGF-C. FASEB J. 2002;16:U20104–30.

    Google Scholar 

  90. Yoon YS, Murayama T, Gravereaux E, Tkebuchava T, Silver M, Curry C, et al. VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema. J Clin Invest. 2003;20101:717–25.

    Google Scholar 

  91. Cao R, Eriksson A, Kubo H, Alitalo K, Cao Y, Thyberg J. Comparative evaluation of FGF-2-, VEGF-A-, and VEGF-C-induced angiogenesis, lymphangiogenesis, vascular fenestrations, and permeability. Circ Res. 2004;94:664–70.

    Article  PubMed  CAS  Google Scholar 

  92. Saito Y, Nakagami H, Morishita R, Takami Y, Kikuchi Y, Hayashi H, et al. Transfection of human hepatocyte growth factor gene ameliorates secondary lymphedema via promotion of lymphangiogenesis. Circulation. 2006;20104:201077–84.

    Google Scholar 

  93. Jussila L, Alitalo K. Vascular growth factors and lymphangiogenesis. Physiol Rev. 2002;82: 673–700.

    PubMed  CAS  Google Scholar 

  94. Kaviani A, Fatch M, Yousefi Nooraie R, Alinagi-zadch MR, Ataie-Fashtami L. Low-level laser therapy in management of postmastectomy lymphedema. Lasers Med Sci. 2006;21:90–4.

    Article  PubMed  Google Scholar 

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  1. Stanford Center for Lymphatic and Venous Disorders, Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA

    Stanley G. Rockson

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    Frederick Dirbas

  2. Iowa City, USA

    Carol Scott-Conner

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Rockson, S.G. (2010). Managing Breast Cancer-Associated Lymphedema. In: Dirbas, F., Scott-Conner, C. (eds) Breast Surgical Techniques and Interdisciplinary Management. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6076-4_84

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