Affiliations: [a] Department of General Surgery, All India Institute of Medical Sciences, Patna, India | [b] Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, India
Correspondence:
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Corresponding author: Dr. Chandan Kumar Jha, Assistant Professor (Endocrine Surgery), Department of General Surgery, All India Institute of Medical Sciences, Patna 801507, India. Tel.: +91 9506280394; E-mail: cjhadmch@gmail.com
Abstract: Lymphedema (LE) in a breast cancer patient usually results from axillary lymph node dissection, sentinel lymph node biopsy, and/or axillary radiotherapy. Although lymphatic obstruction and consequent LE can occur due to axillary lymph node involvement, such presentation in breast cancer patients has rarely been reported. This report describes the case of a 50-year-old lady with right breast carcinoma who presented with right upper limb lymphedema. Surprisingly, she did not have any bulky axillary lymphadenopathy that could have accounted for lymphedema of the upper limb, but a suspicious breast mass was present on clinical examination. Diagnosis of breast cancer on clinical examination can be challenging in such patients due to breast edema and careful imaging of the breast and axilla with appropriate imaging tools (mammogram, ultrasound, MRI, PET mammography) should be resorted to before excluding malignancy. Lymphoscintigraphy confirmed the findings of lymphedema in the right upper limb and revealed uptake in the epitrochlear lymph nodes of the contralateral limb suggesting that she might had pre-existing widespread “subclinical lymphedema” which presented as “clinical lymphedema” in right upper limb after axillary lymph node/lymphatic involvement by right breast carcinoma.
Keywords: Breast carcinoma, lymphedema of the upper limb, axillary lymphadenopathy, lymphoscintigraphy
DOI: 10.3233/BD-230022
Journal: Breast Disease, vol. 42, no. 1, pp. 395-399, 2023
