Considerations for Clinicians in the Diagnosis, Prevention, and Treatment of Breast Cancer-Related Lymphedema: Recommendations from a Multidisciplinary Expert ASBrS Panel

McLaughlin, Sarah A.; Staley, Alicia C; Vicini, Frank A.; Thiruchelvam, Paul; Hutchison, Nancy A; Mendez, Jane; MacNeill, Fiona; Rockson, Stanley G.; DeSnyder, Sarah M.; Klimberg, Suzanne; Alatriste, Michael; Boccardo, Francesco; Smith, Mark L.; Feldman, Sheldon

doi:10.1245/s10434-017-5982-4

Cited by 98 publications

(72 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The standard methods for obtaining limb measurements include perometry, limb circumference and water displacement (1). However, results vary widely because they depend on the subjective estimation of operators, and the assessment of volume alone is insufficient (62). Diagnosis tools such as ultrasound and DXA, which allow assessment of arm tissue composition, should be recommended for patients in which the thickness of muscle in the affected arm is less than that in the unaffected arm, and the muscle growth rates differ between the arms (63).…”

Section: Diagnosis and Surveillancementioning

confidence: 99%

Lymphedema in survivors of breast cancer (Review)

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

The tremendous improvement of survival in patients with breast cancer can be attributed to several treatment strategies, but these strategies also lead to the occurrence of breast cancer-related lymphedema (BCRL). BRCL is regularly associated with factors such as axillary lymph node dissection and local lymph node radiotherapy and manifests as an increase of >10% in the volume of affected limbs. Being overweight or having obesity (body mass index ≥25 kg/m 2 ), an excessive number of positive lymph nodes (>8) and capsular invasion by a tumor are additional risk factors for lymphedema. It is worth assessing the risk before surgery as this can prevent the occurrence of BCRL at the initial stage of breast cancer management. The clinical utility of many diagnostic tools and lymphedema surveillance allows early stage and even subclinical BCRL to be diagnosed, and allows real-time monitoring of the disease. The early diagnosis of BRCL allows treatment at an early stage, which is beneficial to the reduction of excess limb volume and the improvement of quality of life. At present, the major therapeutic methods of BCRL include complex decongestive therapy, pneumatic compression devices, participating in exercise, microsurgery and liposuction, each of which alleviates lymphedema effectively. No medications for treatment of BRCL have yet been developed. However, the recent findings on the success of molecular therapy in animal models may remedy this deficiency. Furthermore, the volume reduction of swollen limbs without swelling rebound by transplanting autologous stem cells has been successfully reported in some pilot studies, which may provide a new technique for treating BCRL. This review aimed to discuss the pathogenesis, clinical manifestation, risk factors, advantages and disadvantages of diagnostic tools, lymphedema surveillance and the characteristics of traditional and newly emerging BCRL treatments.

show abstract

Section: Diagnosis and Surveillancementioning

confidence: 99%

Lymphedema in survivors of breast cancer (Review)

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

show abstract

“…46 Due to the difficulty in predicting populations at risk for developing lymphedema after undergoing breast cancer surgery, clinicians recommend risk-reducing behavior as the primary preventative measure in all patients undergoing axilla surgery. 47 The most widely recognized of these is the avoidance of venipuncture, injections, or taking blood pressure on the side of the affected arm, as well as the use of compression sleeves for air travel. 47 Women who receive lymphedema education prior to treatment, exercise regularly, and implement preventative self-care activities demonstrate a lower incidence of lymphedema following breast cancer surgery.…”

Section: Development Of Lymphedemamentioning

confidence: 99%

“…47 The most widely recognized of these is the avoidance of venipuncture, injections, or taking blood pressure on the side of the affected arm, as well as the use of compression sleeves for air travel. 47 Women who receive lymphedema education prior to treatment, exercise regularly, and implement preventative self-care activities demonstrate a lower incidence of lymphedema following breast cancer surgery. 14,48…”

Section: Development Of Lymphedemamentioning

confidence: 99%

Breast Cancer and Lymphedema: A Narrative Review

Michaelides

Constantinou

2019

Int J Med Students

View full text Add to dashboard Cite

Breast cancer is the second most common cancer diagnosed worldwide, and the leading cause of cancer death in women. The understanding of disease presentation by patients and health care providers is crucial for a correct diagnosis and management. Preventive measures emphasize risk-reducing behaviors such as a healthy diet, reduced alcohol consumption, increased physical activity, and breastfeeding children. Screening techniques such as mammography, ultrasound, and MRI aid in early detection. Following the screening, a breast biopsy is performed, and a histopathological assessment is carried out to confirm a breast cancer diagnosis. In addition to surgery, radiotherapy, and lifestyle modifications, treatment regimens include a range of medications such as anti-hormonal drugs and chemotherapy. Lymphedema is a severe and major long-term consequence of breast cancer treatment. The major contributors to the diminished lymph drainage are a lumpectomy/mastectomy procedure that involves the surgical removal of lymph nodes, and radiotherapy. The fluid accumulation of lymphedema poses physical limitations to the patient and impacts the overall quality of life. A sentinel lymph node biopsy is an essential method of identifying the first draining lymph nodes affected by metastasis. This procedure allows surgeons to later remove only affected lymph nodes, sparing those that are unaffected and hence reduce the risk and magnitude of lymphedema development. Patients who receive education about lymphedema demonstrate higher compliance with treatment and self-care management practices. The purpose of this review is to provide information about breast cancer, the development of lymphedema, and how to recognize and manage both.

show abstract

“…procedure in the prevention of secondary arm lymphedema and LY.M.P.H.A. technique was included among the surgical procedures to prevent breast cancer related lymphedema [19][20][21][22] .…”

Section: Recent Advances In the Treatment Of Breast Cancer Specificamentioning

confidence: 99%