Risk factors of breast cancer-related lymphoedema: protocol of an umbrella review

Abstract

IntroductionBreast cancer-related lymphoedema (BCRL) is a progressive and debilitating complication post-breast cancer treatment. Identifying potential risk factors facilitates the prevention and management of BCRL. Multiple systematic reviews have been conducted to address the variables correlated with the occurrence of BCRL. This study aims to identify and examine factors predicting the development of BCRL, to clarify the predicting mechanism of these factors, as well to determine the credibility of risk factors for BCRL.Methods and analysisThis umbrella review will be conducted with the methodological guidance of the Joanna Briggs Institute and the Cochrane handbook. A comprehensive systematic search will be performed in ten databases: PubMed, Embase, CINAHL, Web of Science, Scopus, CNKI, SinoMed, Wangfang database, the JBI Database of Systematic Reviews, Cochrane Database of Systematic Reviews. The search for unpublished studies will include ProQuest and the PROSPERO register. Reference lists will also be hand searched. Two reviewers will independently screen the studies, extract data and assess the methodological quality using the Methodological Quality of Systematic Reviews-2 and the Risk of Bias in Systematic Reviews. The degree of overlap between included reviews will be assessed by calculating the Corrected Covered Area. The credibility of the associations between risk factors and lymphoedema will be graded into four classes: convincing, highly suggestive, suggestive and weak, referring to the classification system of recent umbrella reviews. A descriptive, narrative synthesis and suggestions for clinical practice and future research will be made based on included systematic reviews, considering the quality of the evidence.Ethics and disseminationEthical approval is not required for this umbrella review. We will seek to submit the results for publication in a peer-reviewed journal or present it at conferences.PROSPERO registration numberCRD42022375710.

Umbrella review protocol: Global burden and risk factors of erectile dysfunction in diabetic population

“…Furthermore, this umbrella review also suffers from a common limitation observed in most umbrella reviews, 40–42 wherein new and recent individual articles may not be included if they have not been incorporated into published systematic reviews and meta‐analyses. This restriction can result in the omission of potentially relevant studies that have emerged since the publication of the included reviews, thus limiting the comprehensiveness and currency of the synthesized evidence.…”

Upper Limb Symptoms in Breast Cancer Survivors with Lymphedema: A Latent Class Analysis and Network Analysis

“…), ultimately impacting work capacity and overall quality of life. [3][4][5][6] The current treatment options for the BCRL include complete decongestive therapy (CDT) [7] (including bandaging, compression garments, and manual lymphatic drainage), pneumatic compression, low-level laser therapy, physical exercise, acupuncture, surgery, etc. [1] Most clinicians base their decision to recommend the treatment options on patients' objective measurement of lymphedema, ignoring their self-reported symptoms.…”