Preventive strategies for breast cancer–related lymphedema: Working toward optimal patient selection

Hyland, Colby J.; Manrique, Oscar J.; Weiss, Anna; Broyles, Justin M.

doi:10.1002/cncr.34374

Cited by 1 publication

(1 citation statement)

References 25 publications

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“…While LYMPHA may be a promising technique, expertise in microsurgery, coordination between breast and plastic surgeons, and an upfront decision before surgery are required [ 67 ]. Additionally, there is risk associated with LYMPHA and a surgical learning curve.…”

Section: Bcrl Preventionmentioning

confidence: 99%

Advances in the prevention and treatment of breast cancer-related lymphedema

Donahue¹,

MacKenzie²,

Filipović³

et al. 2023

Breast Cancer Res Treat

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Purpose Breast cancer-related lymphedema (BCRL) represents a lifelong risk for breast cancer survivors and once acquired becomes a lifelong burden. This review summarizes current BCRL prevention and treatment strategies. Findings Risk factors for BCRL have been extensively studied and their identification has affected breast cancer treatment practice, with sentinel lymph node removal now standard of care for patients with early stage breast cancer without sentinel lymph node metastases. Early surveillance and timely management aim to reduce BCRL incidence and progression, and are further facilitated by patient education, which many breast cancer survivors report not having adequately received. Surgical approaches to BCRL prevention include axillary reverse mapping, lymphatic microsurgical preventative healing (LYMPHA) and Simplified LYMPHA (SLYMPHA). Complete decongestive therapy (CDT) remains the standard of care for patients with BCRL. Among CDT components, facilitating manual lymphatic drainage (MLD) using indocyanine green fluorescence lymphography has been proposed. Intermittent pneumatic compression, nonpneumatic active compression devices, and low-level laser therapy appear promising in lymphedema management. Reconstructive microsurgical techniques such as lymphovenous anastomosis and vascular lymph node transfer are growing surgical considerations for patients as well as liposuction-based procedures for addressing fatty fibrosis formation from chronic lymphedema. Long-term self-management adherence remains problematic, and lack of diagnosis and measurement consensus precludes a comparison of outcomes. Currently, no pharmacological approaches have proven successful. Conclusion Progress in prevention and treatment of BCRL continues, requiring advances in early diagnosis, patient education, expert consensus and novel treatments designed for lymphatic rehabilitation following insults.

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Section: Bcrl Preventionmentioning

confidence: 99%