Reducing rates of chronic breast cancer–related lymphedema with screening and early intervention: an update of recent data

Whitworth, Pat W.; Vicini, Frank A.; Valente, Stephanie A.; Brownson, Kirstyn E.; Dupree, Beth; Kohli, Manpreet; Lawson, Laura; Shah, Chirag

doi:10.1007/s11764-022-01242-8

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…6 Short-course compression therapy as treatment of sBCRL has been shown to improve outcomes and may prevent the need for CDP. [7][8][9][10][11][12] This secondary analysis expands on previously reported risk factors from the PREVENT study. 4 Four axillary treatment groups were based on surgery and radiation to the axilla as previously defined.…”

Section: Introductionmentioning

confidence: 84%

Axillary Treatment and Chronic Breast Cancer–Related Lymphedema: Implications for Prospective Surveillance and Intervention From a Randomized Controlled Trial

Boyages,

Vicini,

Manavi

et al. 2023

JCO Oncol Pract

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Section: Introductionmentioning

confidence: 84%

Axillary Treatment and Chronic Breast Cancer–Related Lymphedema: Implications for Prospective Surveillance and Intervention From a Randomized Controlled Trial

Boyages,

Vicini,

Manavi

et al. 2023

JCO Oncol Pract

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“…However, upper limb lymphedema occurred in both groups in this study, which indicated that BCRL occurred at an early stage (within 4 months) in some patients, suggesting the need for focusing on early prevention and evaluation of early detection and treatment of BCRL. 10 This study found that implementing preventive measures and nursing interventions related to lymphedema were safe and beneficial, but the effectiveness of prevention of lymphedema should be followed up for a longer time in future studies.…”

Section: Characteristicsmentioning

confidence: 76%

“…Whitworth et al's systematic review showed that prospective BCRL surveillance combined with early detection and intervention could reduce the incidence of chronic BCRL 10 . A systematic review of research on lymphedema self‐management summarized ten categories of self‐management and found that whole‐body exercise, second‐stage CDT, including compression garments, exercise, careful skin care, and compression bandages, might be effective in preventing BCRL 11 .…”

Section: Introductionmentioning

confidence: 99%

“…9 Whitworth et al's systematic review showed that prospective BCRL surveillance combined with early detection and intervention could reduce the incidence of chronic BCRL. 10 A systematic review of research on lymphedema self-management summarized ten categories of self-management and found that whole-body exercise, second-stage CDT, including compression garments, exercise, careful skin care, and compression bandages, might be effective in preventing BCRL. 11 A summary of 24 studies by Fu et al found that breast cancer survivors faced challenges in lymphedema selfmanagement and needed to reestablish a new role balance as well as internal and external resources to regulate negative emotions.…”

Section: Introductionmentioning

confidence: 99%

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Effects of a lymphedema prevention program based on the theory of knowledge–attitude–practice on postoperative breast cancer patients: A randomized clinical trial

et al. 2023

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BackgroundBreast cancer‐related lymphedema (BCRL) is one of the common postoperative complications that severely affects the functions of the arm and quality of life. Since lymphedema is difficult to treat and prone to recurrence, early prevention of lymphedema is crucial.MethodsPatient diagnosed with breast cancer (N = 108) were randomized to the intervention (n = 52) or control group (n = 56). In the intervention group, patients were provided the lymphedema prevention program based on the theory of knowledge–attitude–practice during the perioperative period and the first three chemotherapy sessions (mainly includes health education, seminars, knowledge manuals, sports guidance, peer education, and WeChat group).The limb volume, handgrip strength, arm function, and quality of life were measured in all patients at the baseline, 9 weeks (T1), and 18 weeks (T2) after surgery.ResultsThe incidence of lymphedema in the Intervention group was numerically lower than in the control group after implementing the lymphedema prevention program, but the difference was not statistically significant (T1: 1.9% vs. 3.8%, p = 1.000; T2: 3.6% vs. 7.1%, p = 0.744). However, compared with the control group, the intervention group showed there was less deterioration in handgrip strength (T1 [t = −2.512, p < 0.05] and T2 [t = −2.538, p < 0.05]), improved postoperative upper limb dysfunction (T1 [t = 3.087, p < 0.05] and T2 [t = 5.399, p < 0.05]) and less deterioration in quality of life (T1 [p < 0.05] and T2 [p < 0.05]).ConclusionAlthough the investigated lymphedema prevention program improved arm function and quality of life, it did not reduce the incidence of lymphedema in postoperative breast cancer patients.

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“…Early surveillance with timely intervention reduces both BCRL incidence and severity [ 34 ]. A retrospective study of breast cancer survivors compared those who had begun bioimpedance spectroscopy (BIS) monitoring pre-surgery or within 90 days post-surgery with a cohort for which BIS monitoring began later (median 2.1 years) [ 35 ].…”

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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Reducing rates of chronic breast cancer–related lymphedema with screening and early intervention: an update of recent data

Cited by 5 publications

References 22 publications

Axillary Treatment and Chronic Breast Cancer–Related Lymphedema: Implications for Prospective Surveillance and Intervention From a Randomized Controlled Trial

Axillary Treatment and Chronic Breast Cancer–Related Lymphedema: Implications for Prospective Surveillance and Intervention From a Randomized Controlled Trial

Effects of a lymphedema prevention program based on the theory of knowledge–attitude–practice on postoperative breast cancer patients: A randomized clinical trial

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

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