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Breast Cancer–Related Lymphedema: the Prospective Surveillance Model, Early Intervention Strategies, and Role of Complete Decongestive Therapy

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Abstract

Purpose

This study is to review current evidence for prospective surveillance, early intervention and conservative treatment of breast cancer-related lymphedema (BCRL).

Recent Findings

BCRL screening is imperative. It must begin at preoperative baseline to avoid misdiagnosis and should include subjective and objective measures and clinical exam. Screening allows for early intervention; however, further research is needed to definitively establish its benefit and identify the appropriate treatment threshold to minimize progression. Complete decongestive therapy (CDT) has remained the gold standard for treatment; however, this is resource intensive, and supporting evidence for its components is lacking. Further research regarding the effectiveness of manual lymphatic drainage and CDT is indicated to guide clinical practice.

Summary

BCRL has a tremendous negative impact on quality of life, and efforts to maximize patient outcome should be aggressively pursued. Screening, accurate diagnosis, and evidence-based management are mutually supporting and necessary for a comprehensive BCRL program throughout survivorship.

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Authors and Affiliations

  1. Department of Physical and Occupational Therapy, Massachusetts General Hospital, 15 Parkman Ave, WACC 128, Boston, MA, 02114, USA

    Cheryl L. Brunelle

  2. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, 02114, USA

    Alphonse G. Taghian

Authors
  1. Cheryl L. Brunelle
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  2. Alphonse G. Taghian
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Correspondence to Cheryl L. Brunelle.

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Conflict of Interest

Cheryl L. Brunelle reports grants from Award Number R01CA139118 (AG Taghian); National Cancer Institute, grants from Award Number P50CA08393 (AG Taghian); National Cancer Institute, from the Adele McKinnon Research Fund for Breast Cancer-Related Lymphedema (AG Taghian), from the Olayan-Xefos Family Fund for Breast Cancer Research (AG Taghian), and from the Heinz Family Foundation (AG Taghian), during the conduct of the study, and personal fees from PureTech Health, outside the submitted work.

Alphonse G. Taghian reports grants from Award Number R01CA139118, National Cancer Institute, grants from Award Number P50CA08393, National Cancer Institute, from the Adele McKinnon Research Fund for Breast Cancer-Related Lymphedema (AG Taghian), from the Olayan-Xefos Family Fund for Breast Cancer Research, and from the Heinz Family Foundation, during the conduct of the study; Dr. Taghian is on the Scientific Advisory Board for PureTech Health and has received consulting fees from Vision RT and non-financial support from ImpediMed, outside the submitted work.

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Brunelle, C.L., Taghian, A.G. Breast Cancer–Related Lymphedema: the Prospective Surveillance Model, Early Intervention Strategies, and Role of Complete Decongestive Therapy. Curr Breast Cancer Rep 15, 12–23 (2023). https://doi.org/10.1007/s12609-023-00471-9

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