Prevention of Breast Cancer-Related Lymphedema

McEvoy, Maureen P.; Ravetch, Ethan; Patel, G.; Fox, Jana; Feldman, Sheldon

doi:10.1016/j.clbc.2021.02.009

Cited by 20 publications

(35 citation statements)

References 166 publications

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“…Soran et al showed that monitoring with BIS reduces the incidence of subclinical BCRL from 36.4% to 4.4% (12). Similarly, Whitworth et al demonstrated that 3% of patients had unresolved clinically significant BCRL when BIS was used as surveillance, which is lower than reported in contemporary studies (4,44,45).…”

Section: Assessment and Surveillancementioning

confidence: 93%

“…LyMPHA provides a preventative lymphovenous anastomosis. During an axillary node dissection, if the malignant node is draining the arm, a lympha-vascular anastomosis can be performed (4). In a randomized study in 2011, Boccardo et al compared LyMPHA in 46 patients undergoing complete ALND.…”

Section: Lymphatic Microsurgical Preventive Healing Approachmentioning

confidence: 99%

“…BCRL results from disruption of the lymphatic system. This prevents adequate drainage, allowing lymph fluid to accumulate in the interstitial space ( 2 – 4 ). BCRL has been defined as a 2- cm increase in limb circumference, a 200- mm increase in limb volume, or a 5% to 10% change in limb volume compared to the unaffected arm ( 4 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…Diagnosing pre-clinical lymphedema can be challenging and requires preoperative assessment and surveillance at standardized intervals ( 4 , 7 – 10 ). There are several methods to detect and monitor lymphedema.…”

Section: Introductionmentioning

confidence: 99%

“…Risk factors are subdivided into patient-specific and treatment-specific risk factors. Patient- specific factors include body mass index (BMI) at the time of diagnosis, subclinical edema, and cellulitis on the side of treatment ( 4 ). The independent treatment- related risk factors for BCRL include lymph node surgery ( 16 – 20 ) and regional lymph node radiation (RLNR) ( 21 – 24 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The prevention and treatment of breast cancer- related lymphedema: A review

McEvoy

Gomberawalla²,

Smith

et al. 2022

Front. Oncol.

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BackgroundBreast cancer- related lymphedema (BCRL) affects about 3 to 5 million patients worldwide, with about 20,000 per year in the United States. As breast cancer mortality is declining due to improved diagnostics and treatments, the long-term effects of treatment for BCRL need to be addressed.MethodsThe American Society of Breast Surgeons Lymphatic Surgery Working Group conducted a large review of the literature in order to develop guidelines on BCRL prevention and treatment. This was a comprehensive but not systematic review of the literature. This was inclusive of recent randomized controlled trials, meta-analyses, and reviews evaluating the prevention and treatment of BCRL. There were 25 randomized clinical trials, 13 systemic reviews and meta-analyses, and 87 observational studies included.ResultsThe findings of our review are detailed in the paper, with each guideline being analyzed with the most recent data that the group found evidence of to suggest these recommendations.ConclusionsPrevention and treatment of BCRL involve a multidisciplinary team. Early detection, before clinically apparent, is crucial to prevent irreversible lymphedema. Awareness of risk factors and appropriate practice adjustments to reduce the risk aids are crucial to decrease the progression of lymphedema. The treatment can be costly, time- consuming, and not always effective, and therefore, the overall goal should be prevention.

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Section: Assessment and Surveillancementioning

confidence: 93%

Section: Lymphatic Microsurgical Preventive Healing Approachmentioning

confidence: 99%