![]() The operative method, axillary lymph node dissection (ALND), radiation therapy, and compliance with compression therapy influence the incidence and severity of lymphedema. Lymphedema is one of the complications that reduces the quality of life of breast cancer survivors. ![]() Superficial lymphatic drainage has a connection through the deltopectoral groove. Changes in lymph drainage caused by surgery triggered the activation of the superficial lymphatic drainage system to relieve lymphedema. Bypass lymphatic circulation had two patterns: Infraclavicular lymph nodes and supraclavicular and/or cervical lymph nodes. The positive group showed significantly less swelling than the negative group at the mid-arm, elbow, and 15 cm below the elbow. Fifteen patients (51.7%) had bypass lymphatic systems on the affected side, six (20.7%) had a bypass lymphatic system with axillary lymph nodes on the unaffected side, and 11 (37.9%) showed new lymphatic drainage. Twenty-nine patients were included in this study. The difference in the upper extremity circumference (cm) was measured at four points: Mid-point of the upper arm, elbow, and 10 and 15 cm below the elbow. Exclusion criteria were as follows: History of bilateral breast cancer surgery, cervical lymph node dissection history, and upper extremity amputation. All patients received complete decongestive therapy (CDT). Patients with radioactivity in anatomical locations other than axillary lymph nodes were classified into a positive group. SPECT/CT was performed to detect the three-dimensional locations of radio-activated lymph nodes. Patients who underwent unilateral breast cancer surgery with axillary lymph node dissection were recruited and underwent single-photon emission tomography/computed tomography (SPECT/CT). This was a retrospective, cross-sectional study. Examine the thyroid gland while having the patient swallow and by pushing the thyroid gland from one side while palpating with the other hand.This study aimed to determine whether bypass circulation was present in lymphedema and its effect. Inspect the thyroid gland from the front and from the side and then palpate the thyroid gland using both hands from front or behind the patient. ![]() Submandibular Lymph Node Examinationįollow the lower border of the mandible with the tips of the finger. Palpate the supraclavicular lymph nodes, placing the fingers above the clavicle using firm pressure in small circular movements and feel for gland across the top and slightly behind this bone. Again, if a palpable node is located, describe it with detail (painful, hard, indurated). With the tips of the fingers, move the ECM muscle to the front, and follow the posterior line with gentle but firm pressure. Posterior Cervical Lymph Node Examination If a palpable node is located, describe it with detail (painful, hard, indurated). The lymph node examination is performed with circular motion, identifying pain, and swollen ganglia or induration.įor the anterior cervical lymph node exam, palpate the lymph nodes in the neck using circular motion over the underlying tissues in each area. The PPE does not reflect the actual requirements for patient care. NOTE: Video recorded previous to COVID-19 pandemic. Below is a video showing the proper technique and a written explanation of what is expected from dentists when performing a lymph node and thyroid gland examination. A lymph node evaluation should be included in all new patients as part of the oral cancer triage.
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