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. 2017 Jun;9(2):111-121.
doi: 10.1007/s12609-017-0237-8. Epub 2017 May 3.

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

Hoda E Sayegh  1 , Maria S Asdourian  1 , Meyha N Swaroop  1 , Cheryl L Brunelle  2 , Melissa N Skolny  1 , Laura Salama  1 , Alphonse G Taghian  1
Affiliations

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

Hoda E Sayegh et al. Curr Breast Cancer Rep. 2017 Jun.

Abstract

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.

Keywords: Breast cancer-related lymphedema; Diagnosis; Management; Prevention; Risk factors; Survivorship.

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Conflict of interest statement

Conflict of Interest Hoda Sayegh, Maria Asdourian, Meyha Swaroop, Cheryl Brunelle, Melissa Skolny, and Laura Salama declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Histogram of arm asymmetry. Baseline asymmetries of >5 and 10% are shaded light and dark pink, respectively
Fig. 2
Fig. 2
Relative volume change after a 200-mL arm volume increase
See this image and copyright information in PMC

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