Balancing Lymphedema Risk

Objective To determine if adherence to self-care modalities for breast cancer-related lymphedema (BCRL) predicts BCRL outcomes among 128 breast cancer (BrCa) survivors who participated in the 12-month physical activity and lymphedema (PAL) trial. Design This was a prospective cohort study. Adherence to 10 BCRL self-care modalities, as recommended in the clinical practice guidelines for the management of BCRL was assessed by questionnaire at baseline. BCRL outcomes assessed at baseline and 12-months included volumetry, circumferences, bioimpedence spectroscopy, the Norman lymphedema survey, and clinician-defined lymphedema exacerbations requiring treatment. Generalized linear models were used to estimate the relationship between adherence to BCRL self-care modalities and the likelihood of experiencing a BCRL outcome. Results Adherence to BCRL self-care activities did not predict experiencing any BCRL outcomes at 12-months. Levels of adherence to BCRL self-care modalities did not predict a ≥5% decrease in interlimb volume (Ptrend=0.79), ≥5% decrease in the sum of interlimb arm circumferences (Ptrend=0.47), ≥10% decrease in bioimpedence spectroscopy (Ptrend=0.83), ≥1 decrease in self-reported lymphedema symptoms (Ptrend=0.91), or clinician-defined lymphedema exacerbation requiring treatment (Ptrend=0.84). Conclusions Our findings suggest levels of BCRL self-care adherence do not predict BCRL outcomes among BrCa survivors with stable lymphedema who were followed for 12-months.

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“…Nonetheless, these data suggest new strategies and methods to maintain arm health are needed among BrCa survivors with BCRL. 25 …”

Section: Discussionmentioning

confidence: 99%

“…Thus, weight-lifting may be a time-efficient multidimensional intervention to promote the health and longevity of BrCa survivors with BCRL. 25 …”

Section: Discussionmentioning

confidence: 99%

Association Between Lymphedema Self-Care Adherence and Lymphedema Outcomes Among Women with Breast Cancer-Related Lymphedema

Brown

Kumar

Cheville

et al. 2015

American Journal of Physical Medicine &Amp; Rehabilitation

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“…Awareness of an initial episode of transient swelling provides an opportunity for early intervention which may theoretically preempt progression to a chronic state. Finally, a growing body of evidence suggests that exercise does not exacerbate or trigger secondary LE [39, 40]. …”

Section: Risk Reductionmentioning

confidence: 99%

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

Armer

Hulett

Bernas

et al. 2013

Curr Breast Cancer Rep

100

103

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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.

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“…SL is likely to occur after the surgical removal of lymph nodes or in conjunction with radiotherapy [3]. SL is generally described as ‘arm swelling and dysfunction' [4] and is defined as an increase in arm circumference by more than 2 cm [5] or as an accumulation of excessive protein-rich liquid in a part of the body where lymphatic vessels have been damaged [6]. About 20-30% of all breast cancer patients develop SL [7].…”

Section: Introductionmentioning

confidence: 99%

Does Exercise Have a Preventive Effect on Secondary Lymphedema in Breast Cancer Patients Following Local Treatment - A Systematic Review

et al. 2018

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Background: Secondary lymphedema (SL) is a possible side effect of breast cancer treatment. Current data describe a positive influence of exercise on upper lymphedema. This systematic review evaluates studies examining a potential preventive effect of exercise on SL incidence. Methods: A systematic literature search of PubMed, LIVIVO, and the Cochrane Library was performed. Results: 8 randomized controlled trials were included in the review. 3 studies investigated the effect of strength training, and 5 the effect of combined exercise therapy. 5 studies included participants without lymphedema at study entry, and 3 studies included both patients with and without lymphedema. The partly significant results showed that progressive strength training as well as combined dynamic exercise therapies consisting of physiotherapy, physical therapy, and/or kinesiotherapy are safe and can prevent SL. Onset as well as diagnosis of lymphedema were significantly decreased in 5 studies in the exercise group. Conclusion: All 8 studies included indicate a potential preventive effect of exercise on SL; however, further research is needed.

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Balancing Lymphedema Risk

Cited by 80 publications

References 31 publications

Association Between Lymphedema Self-Care Adherence and Lymphedema Outcomes Among Women with Breast Cancer-Related Lymphedema

Association Between Lymphedema Self-Care Adherence and Lymphedema Outcomes Among Women with Breast Cancer-Related Lymphedema

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

Does Exercise Have a Preventive Effect on Secondary Lymphedema in Breast Cancer Patients Following Local Treatment - A Systematic Review

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