Best Practice Guidelines in Assessment, Risk Reduction, Management, and Surveillance for Post-Breast Cancer Lymphedema

Abstract

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.

Keywords: Breast cancer; Combined decongestive therapy; Complementary; Compression garment; Exercise; Intermittent pneumatic compression pump; Limb volume; Lymphatic; Lymphedema; Management; Manual lymphatic drainage; Practices; Risk reduction; Surveillance.

Figure 1

Conceptual model of biopsychosocial factors influencing post–breast cancer lymphedema. Adapted from Armer et al. [8]. Rehabilitation concepts among aging survivors living with and at risk for lymphedema: A framework for assessment, enhancing strengths, and minimizing vulnerability. Top Geriatr Rehabil 2012;28(4):260-8.