Breast cancer-related lymphedema (LE) is a progressive, chronic disease that affects millions of cancer survivors and primarily results from surgical lymphatic vessel/node removal and radiation therapy. Patient education and support for importance of early detection is essential in helping health care providers detect lymphedema early, when there is the best chance to prevent progression. Improved imaging and surgical techniques have decreased the incidence of LE; however, effective risk-reduction and treatment have historically lacked the level of evidence necessary to standardize effective treatment. The purpose of this article is to report an extensive review of literature, including highlighted multidisciplinary studies within the past three years, in order to update best practice guidelines in assessment, risk reduction, management, and surveillance for post-breast cancer lymphedema.
that few behavioral intervention studies were conducted on improving adherence to ET therapy. Therefore, the purposes of this systematic review were to explore studies that examined the impact of interventions or strategies to improve ET adherence among women with BrCa, and identify studies offering insights for future researchers designing interventions to improve ET adherence. Given the known health disparities of BrCa survivors that may contribute to lack of ET adherence, 18,27,28 we additionally sought to examine whether any studies discussed adaptations or considerations aimed to target the unique needs of disparate populations. Methods Inclusion and Exclusion Criteria. Studies included in this review met the following criteria: original research in peer-reviewed journals, full-text available online, clearly stated descriptions of samples and methodology, human subjects, adults, and articles available in English. We focused on papers that examined strategies and approaches for improving adherence to ET among women with BrCa. We defined ET as tamoxifen and/or aromatase inhibitors, the two major classes of drugs used for hormone positive BrCa. We included studies with a broad range of designs to capture data that examined a direct relationship between adherence and any strategy that could be replicated in an intervention. For example, if a study reported modifiable factors e.g., self-efficacy, patient-provider communication)in association with adherence as an outcome, we included the study. We excluded any descriptive manuscripts which did not document strategies to improve adherence. Search Strategy.
Objective measures of DSC sampling that include enough collection time points to assess DSC parameters would increase the rigor of future DSC measurement. Breast cancer survivors may benefit from nursing care that includes spiritual assessment and therapeutic conversations that support positive spiritual beliefs.
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