Objective: To establish a consensus regarding the multidisciplinary prevention of breast cancer-related lymphedema (BCRL), taking into account the expert opinion of professional groups from across the world involved in the identification and treatment of breast cancers.Methods: International consensus study involving a modified nominal group and Delphi process. A total of 50 preventive strategies representing those used by a range of health disciplines involved in breast cancer care were identified by the nominal group. These strategies were categorised into four subgroups (general recommendations, therapeutic approach, rehabilitation medicine and physiotherapy and dietary recommendations) and presented in survey format to a multidisciplinary panel of experts in a two-round Delphi process. Eleven specialist areas and 15 countries were represented on the panel.Results: Twenty-seven experts responded to both Delphi rounds, and the mean overall agreement after Round 2 was 85.7%. Of the 50 proposed strategies for preventing BCRL, 48 yielded consensus among experts. Conclusion:We report an international consensus for the multidisciplinary prevention of BCRL, setting out recommendations aimed at systematising the care of women with breast cancer. The consensus could provide a platform for the development of standardised clinical guidelines.

Introducción. Un linfedema es el aumento de fluido rico en proteínas y macromoléculas en el espacio intersticial de un segmento corporal con incremento de volumen en el miembro afectado, el cual causa cambios fibroescleróticos progresivos en los tejidos.Objetivo. Informar sobre la evolución clínica y el análisis de la progresión de un paciente de 52 años con linfedema bilateral primario estadio II.Presentación del caso. Paciente masculino de 52 años quien había sufrido por más de 20 años edema linfostático; el sujeto había recibido diversas opiniones y tratamientos inefectivos los últimos 5 años, hasta que llegó a la Clínica Godoy en Sao Jose de Rio Preto, Brasil, en el año 2016, en donde fue sometido a proceso de terapia intensiva según el modelo de tratamiento propuesto por Godoy & Godoy.Conclusión. Se obtuvieron resultados favorables en un periodo muy corto de tiempo; durante el proceso se observaron distintas evoluciones clínicas en cada pierna, aun recibiendo ambas el mismo tratamiento.

Backgroundː There is a lack of clinical and epidemiological knowledge about cancer-related lymphedema in Mexico. The objective of this study is to present a broad and deep report of cancer-related lymphedema’s clinical characteristics and epidemiological features based on the analysis of CRL patients’ data, collected from a specialized rehabilitation clinic in Mexico. Methodsː This is a cohort study based on the analysis of clinical data gathered between 2015 and 2022. The study was developed in a private clinic that specializes in oncological patients’ rehabilitation. Clinical assessments and interviews were performed to collect each case’s clinical history, considering diverse clinical characteristics and demographic information, classified in a matrix, and statistically evaluated. Resultsː Among 307 lymphedema patients, gender distribution was represented by 87.9% (270) female and 12.1% (37) male; mean age of 54.5 years (± 32.5); 79.8% of the patients corresponded to breast cancer diagnosis, the rest of them were associated with other 19 different types of cancer. 90.2% of patients underwent some lymph node removal procedure, 68.1% of patients received fractioned radiotherapy sessions, and 87.7% received some chemotherapy scheme treatment. 64% of patients had a diagnosis of lymphedema and had onset symptoms of lymphedema in the first 5 years after oncological interventions and/or cancer diagnosis, most of them during the first 2 years. The general distribution of clinical staging was: 23.7% in stage 0; 20.1% in stage I; 44.6% in stage II, and in stage III 11.4%. Regarding body mass index, it was found a mean of 26.7 BMI. 61.2% of patients ranged between overweight and obesity. 43.3% of patients with CRL reported a disability to perform one or more activities due to lymphedema. 80% of patients had no physical activity or performed under the minimal physical activity recommended for the population group they belong. Conclusionː This study reports broad epidemiological and clinical features of a group of cancer-related lymphedema patients in Mexico, it was possible to identify diverse potential factors and relations that influence the clinical features of CRL; it is necessary to explore all factors and the interactions among them for a better understanding of CRL patients in the country.

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Introduction: Secondary lymphedema is defined as a chronic-progressive disease that causes rich protein edema of the limbs, this may be caused due to the damage or obstruction of lymphatic structures; complications associated with loxosceles spider bite may cause damage to the lymphatic system. Objective: To describe the clinical case of a patient with lower extremity lymphedema secondary to loxosceles' spider bite complications and to present a literature review on the topic. Case Presentation: A 24-year-old man received previous medical attention between 2020-and 2021 due to complications of a loxosceles brown spider bite. He arrived at our facilities in January 2022 to assess his case related to progressive volume leg increase and a chronic wound in the bitten site. After the clinical history analysis, physical examination, and a near-infrared lymphography study of the leg, damage to lymphatic structures was identified; secondary lymphedema was confirmed. It was possible to reverse and control the lymphedema volume and the wound evolved to complete closure. The case is presented along with a literature review on the topic. Conclusion: It is presented a case of lymphedema associated with a loxosceles brown spider bite, and successfully treated. Lymphedema related to a loxosceles spider bite and its complications is a clinical reality that might be underrecognized by scientific literature and clinicians; this condition should be properly studied and considered with adequate assessment strategies in patients after suffering the spider bite in extremities, especially in the mid and long-term.