Ann Rehabil Med.  2019 Feb;43(1):81-86. 10.5535/arm.2019.43.1.81.

Diagnostic Significance of Fibrin Degradation Products and D-Dimer in Patients With Breast Cancer-Related Lymphedema

• Ryu SH
• Min SW
• Kim JH
• Jeong HJ
• Kim GC
• Kim DK
• Sim YJ

• KMID: 2440955
• DOI: http://doi.org/10.5535/arm.2019.43.1.81

Abstract

OBJECTIVE
To find out whether levels of fibrin degradation products (FDP) and D-dimer are increased in breast cancer-related lymphedema (BCRL) as in many vascular diseases. FDP and D-dimer have been used in blood tests to help differentiate deep vein thrombosis in the diagnosis of lymphedema. Levels of FDP and D-dimer are often elevated in patients with BCRL.
METHODS
Patients with BCRL (group I), non-lymphedema after breast cancer treatment (group II), and deep venous thrombosis (group III) from January 2012 to December 2016 were enrolled. Levels of FDP and D-dimer were measured in all groups and compared among groups.
RESULTS
Mean values of FDP and D-dimer of group I were 5.614±12.387 and 1.179±2.408 μg/μL, respectively. These were significantly higher than their upper normal limits set in our institution. Levels of FDP or D-dimer were not significantly different between group I and group II. However, values of FDP and D-dimer in group III were significantly higher than those in group I.
CONCLUSION
Values of FDP and D-dimer were much higher in patients with thrombotic disease than those in patients with lymphedema. Thus, FDP and D-dimer can be used to differentiate between DVT and lymphedema. However, elevated levels of FDP or D-dimer cannot indicate the occurrence of lymphedema.

Keyword

Breast cancer related lymphedema; Fibrin degradation products; D-dimer; Deep vein thrombosis

MeSH Terms

Breast Neoplasms
Breast*
Diagnosis
Fibrin Fibrinogen Degradation Products*
Fibrin*
Hematologic Tests
Humans
Lymphedema*
Vascular Diseases
Venous Thrombosis
Fibrin
Fibrin Fibrinogen Degradation Products

Figure

• 

  Fig. 1. Comparison of values of FDP (A) and D-dimer (B) in each group. FDP, fibrin degradation products.

• 

  Fig. 2. Receiver operating characteristic curve and AUC of FDP (A) or D-dimer (B) in lymphedema group and deep vein thrombosis group. AUC, area under the curve; FDP, fibrin degradation products.

• 

  Fig. 3. Ultrasonographic findings of upper extremity deep vein thrombosis. Axial image of axillary vein (A) using color Doppler with compression (B).

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