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Review
. 2022 Dec 6:12:1062472.
doi: 10.3389/fonc.2022.1062472. eCollection 2022.

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

Maureen P McEvoy  1 , Ameer Gomberawalla  2 , Mark Smith  3 , Francesco M Boccardo  4 , Dennis Holmes  5 , Risal Djohan  6 , Paul Thiruchelvam  7 , Suzanne Klimberg  8 , Jill Dietz  9 , Sheldon Feldman  1
Affiliations
Review

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

Maureen P McEvoy et al. Front Oncol. .

Abstract

Background: Breast 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.

Methods: The 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.

Results: The 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.

Conclusions: Prevention 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.

Keywords: LyMPHA; axillary reverse mapping; axillary surgery; breast cancer; breast cancer related lymphedema; lymphedema.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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