Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis

Asdourian, Maria S.; Skolny, Melissa N.; Brunelle, Cheryl L.; Seward, C.; Salama, Laura; Taghian, Alphonse G.

doi:10.1016/s1470-2045(16)30204-2

Cited by 86 publications

(79 citation statements)

References 64 publications

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“…In this study, 22% of the patients with cellulitis developed recurrent episodes of cellulitis, which was more prevalent in patients with BCRL. Thus, cellulitis may increase the risk for developing BCRL, and vice versa [3•, 24•, 27], but further exploration is needed to understand the relationship between lymphedema development and cellulitis [24•]. …”

Section: Risk Factorsmentioning

confidence: 99%

“…Reported BCRL incidence in the literature ranges from 5 to 50% [3•]. A recent meta-analysis estimates that approximately one in five breast cancer survivors will develop BCRL [4] with a median onset of 14–18 months after surgery [5].…”

Section: Introductionmentioning

confidence: 99%

“…As a result of ongoing research regarding patient outcomes from radiation and lymph node surgery, physicians have shifted away from more invasive, high-risk surgical and treatment approaches [1–17]. There are several studies that have identified risk factors for BCRL, allowing practitioners to identify those at the highest risk for developing BCRL [3•, 4, 5, 18–27, 28•]. Lastly, research in the management and treatment of BCRL has allowed for significant improvements in patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Methods, Risk Factors, Prevention, and Management of Breast Cancer-Related Lymphedema: Past, Present, and Future Directions

Sayegh

Asdourian

Swaroop

et al. 2017

Curr Breast Cancer Rep

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Purpose of Review Breast cancer-related lymphedema (BCRL) is a chronic, adverse, and much feared complication of breast cancer treatment, which affects approximately 20% of patients following breast cancer treatment. BCRL has a tremendous impact on breast cancer survivors, including physical impairments and significant psychological consequences. The intent of this review is to discuss recent studies and analyses regarding the risk factors, diagnosis, prevention through early screening and intervention, and management of BCRL. Recent Findings Highly-evidenced risk factors for BCRL include axillary lymph node dissection, lack of reconstruction, radiation to the lymph nodes, high BMI at diagnosis, weight fluctuations during and after treatment, subclinical edema within and beyond 3 months after surgery, and cellulitis in the at-risk arm. Avoidance of potential risk factors can serve as a method of prevention. Through establishing a screening program by which breast cancer patients are measured pre-operatively and at follow-ups, are objectively assessed through a weight-adjusted analysis, and are clinically assessed for signs and symptoms, BCRL can be tracked accurately and treated effectively. Management of BCRL is done by a trained professional, with research mounting towards the use of compression bandaging as a first line intervention against BCRL. Finally, exercise is safe for breast cancer patients with and without BCRL and does not incite or exacerbate symptoms of BCRL. Summary Recent research has shed light on BCRL risk factors, diagnosis, prevention, and management. We hope that education on these aspects of BCRL will promote an informed, consistent approach and encourage additional research in this field to improve patient outcomes and quality of life in breast cancer survivors.

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Section: Risk Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic Methods, Risk Factors, Prevention, and Management of Breast Cancer-Related Lymphedema: Past, Present, and Future Directions

Sayegh

Asdourian

Swaroop

et al. 2017

Curr Breast Cancer Rep

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“…Well-defined risk factors for developing LE in cancer patients include extensive surgery (i.e. ALND), greater number of lymph nodes dissected, mastectomy, regional lymph node irradiation, infection, obesity, older age at diagnosis and low physical activity levels [71,73,76,77,78]. …”

Section: Lymphedemamentioning

confidence: 99%

“…ipsilateral blood draws or injections) and air travel to prevent potential infection. Most of these recommendations, although found in National guidelines [74,79], yet remain unsustained by high-level scientific evidence [78]. A recent large prospective study [80] showed no significant association between these potential risk factors and the subsequent risk of LE.…”

Section: Lymphedemamentioning

confidence: 99%

Rehabilitation of Cancer Survivors with Long-Term Toxicities

Schmielau¹,

Rick

Reuß‐Borst³

et al. 2017

Oncol Res Treat

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The prognosis of cancer patients is constantly improving, which increases the importance of securing long-term quality of life. While therapy of treatment-related disability mostly succeeds a cancer-specific treatment, physicians' awareness of simultaneous supportive therapy is rising. Early interventions such as physical exercise during chemotherapy are effective in reducing conditions such as fatigue. Specific sensorimotor training is able to improve or even prevent impairment of balance caused by neurotoxic agents. Although targeted therapies reduce the risk of side effects, combinations with established drugs have to be monitored with regard to cardiotoxicity, which is already a concern in children's cancer therapy and is now also focused on in long-term adult survivors. Improvement in diagnosis und surgical procedures have reduced impairments such as lymphedema. Furthermore, management and quality of life of breast cancer patients benefit from evidence showing that physical exercise and resistance training do not increase the risk of developing lymphedema.

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Breast cancer‐related lymphedema correlated with incidence of cellulitis and mortality

Cheng

Tsai

et al. 2022

Journal of Surgical Oncology

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Background This study investigated breast cancer‐related lymphedema (BCRL) and its correlation with the incidence of cellulitis and mortality in the National Health Insurance (NHI) database in Taiwan. Methods Between 2004 and 2014, the NHI database of patients with breast cancer who underwent surgical procedures, adjuvant therapies, BCRL, cellulitis, and mortality were retrospectively reviewed. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incidence of BCRL and cellulitis in different treatment groups. The associations of BCRL with the incidence of cellulitis and mortality were further analyzed using the Kaplan–Meier curve. Results Among 100 301 patients, 5464 (5.4%) developed BCRL with a median onset of 1.3 years. At a mean follow‐up of 4.77 years, the incidence of cellulitis in the BCRL group (12.7%, 694/5464 patients) was significantly higher than in the no‐BCRL group (2.73%, 2589/94 837 patients) (HR: 3.74; 95% CI: 3.43–4.08; p < 0.0001). At a mean follow‐up of 5.77 years, the mortality rate in the cellulitis group (34.21%, 1123/3283 patients) was significantly greater than in the no‐cellulitis group (16.29%, 15 804/97 018 patients) (HR: 1.17; 95% CI: 1.1–1.24; p < 0.0001). Conclusions BCRL had a significantly higher incidence of cellulitis and mortality.

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Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis

Cited by 86 publications

References 64 publications

Diagnostic Methods, Risk Factors, Prevention, and Management of Breast Cancer-Related Lymphedema: Past, Present, and Future Directions

Diagnostic Methods, Risk Factors, Prevention, and Management of Breast Cancer-Related Lymphedema: Past, Present, and Future Directions

Rehabilitation of Cancer Survivors with Long-Term Toxicities

Breast cancer‐related lymphedema correlated with incidence of cellulitis and mortality

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