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Lymphedema Care

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Abstract

Cancer-related lymphedema is an overwhelmingly common condition in cancer survivors worldwide. The causes are diverse, it may be due to surgery, staging procedures, radiation, and other treatments, or it may be secondary to lymphatic tumor invasion. Despite its prevalence, many health care providers are not well-versed in its diagnostic criteria, treatment, or management, owing to the lack of evidence-based literature available to support a true standard of care. In this text, we provide a comprehensive review of the pathophysiology, molecular biology, diagnostic techniques, treatment modalities, quality of life, and psychosocial issues related to this chronic condition. Access to lymphedema evaluation, care, and support is highly variable around the world. Although there are many tools used to treat and manage chronic lymphedema, again access is not uniform. Professional training in this field is not standardized globally, but international efforts to improve the standard of care and promote uniformity are ongoing.

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References

  1. Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol. 2008;26(21):3536–3542.

    Article  PubMed  Google Scholar 

  2. Lawenda BD, Mondry TE, Johnstone PA. Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA Cancer J Clin. 2009;59(1):8–24.

    Article  PubMed  Google Scholar 

  3. Nakamura K, Rockson SG. Molecular targets for therapeutic lymphangiogenesis in lymphatic dysfunction and disease. Lymphat Res Biol. 2008;6(3–4):181–189.

    Article  PubMed  Google Scholar 

  4. Ji RC. Lymphatic endothelial cells, lymphedematous lymphangiogenesis, and molecular control of edema formation. Lymphat Res Biol. 2008;6(3–4):123–137.

    Article  PubMed  CAS  Google Scholar 

  5. O’Brien P. Lymphedema Research 2001.

    Google Scholar 

  6. Cao Y. Why and how do tumors stimulate lymphangiogenesis? Lymphat Res Biol. 2008;6(3–4):145–148.

    Article  PubMed  Google Scholar 

  7. Sarnaik AA, Puleo CA, Zager JS, Sondak VK. Limiting the ­morbidity of inguinal lymphadenectomy for metastatic melanoma. Cancer Control. 2009;16(3):240–247.

    PubMed  Google Scholar 

  8. Garmy-Susini B, Varner JA. Roles of integrins in tumor angiogenesis and lymphangiogenesis. Lymphat Res Biol. 2008;6(3–4):155–163.

    Article  PubMed  CAS  Google Scholar 

  9. Norman SA, Localio AR, Potashnik SL, et al. Lymphedema in breast cancer survivors: incidence, degree, time course, treatment, and symptoms. J Clin Oncol. 2009;27(3):390–397.

    Article  PubMed  Google Scholar 

  10. Bar Ad V, Cheville A, Solin LJ, Dutta P, Both S, Harris EE. Time course of mild arm lymphedema after breast conservation treatment for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2010;76(1):85–90.

    Article  PubMed  Google Scholar 

  11. Deutsch M, Land S, Begovic M, Sharif S. The incidence of arm edema in women with breast cancer randomized on the National Surgical Adjuvant Breast and Bowel Project study B-04 to radical mastectomy versus total mastectomy and radiotherapy versus total mastectomy alone. Int J Radiat Oncol Biol Phys. 2008;70(4):1020–1024.

    Article  PubMed  Google Scholar 

  12. Nesvold IL, Dahl AA, Lokkevik E, Marit Mengshoel A, Fossa SD. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy. Acta Oncol. 2008;47(5):835–842.

    Article  PubMed  Google Scholar 

  13. Golshan M, Martin WJ, Dowlatshahi K. Sentinel lymph node biopsy lowers the rate of lymphedema when compared with standard axillary lymph node dissection. Am Surg. 2003;69(3):209–211; discussion 212.

    PubMed  Google Scholar 

  14. Schijven MP, Vingerhoets AJ, Rutten HJ, et al. Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy. Eur J Surg Oncol. 2003;29(4):341–350.

    Article  PubMed  CAS  Google Scholar 

  15. Chen JJ, Huang XY, Liu ZB, et al. Sentinel node biopsy and quality of life measures in a Chinese population. Eur J Surg Oncol. 2009;35(9):921–927.

    Article  PubMed  Google Scholar 

  16. Boneti C, Korourian S, Bland K, et al. Axillary reverse mapping: mapping and preserving arm lymphatics may be important in preventing lymphedema during sentinel lymph node biopsy. J Am Coll Surg. 2008;206(5):1038–1042; discussion 1042–1044.

    Article  PubMed  Google Scholar 

  17. Hayes SB, Freedman GM, Li T, Anderson PR, Ross E. Does axillary boost increase lymphedema compared with supraclavicular radiation alone after breast conservation? Int J Radiat Oncol Biol Phys. 2008;72(5):1449–1455.

    Article  PubMed  Google Scholar 

  18. Moore RG, Robison K, Brown AK, et al. Isolated sentinel lymph node dissection with conservative management in patients with squamous cell carcinoma of the vulva: a prospective trial. Gynecol Oncol. 2008;109(1):65–70.

    Article  PubMed  Google Scholar 

  19. Bennett Britton TM, Wallace SM, Wilkinson IB, Mortimer PS, Peters AM, Purushotham AD. Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer. Br J Surg. 2009;96(8):865–869.

    Article  PubMed  CAS  Google Scholar 

  20. Pinell XA, Kirkpatrick SH, Hawkins K, Mondry TE, Johnstone PA. Manipulative therapy of secondary lymphedema in the presence of locoregional tumors. Cancer. 2008;112(4):950–954.

    Article  PubMed  Google Scholar 

  21. Ronka RH, Pamilo MS, von Smitten KA, Leidenius MH. Breast lymphedema after breast conserving treatment. Acta Oncol. 2004;43(6):551–557.

    Article  PubMed  Google Scholar 

  22. Petrek JA, Senie RT, Peters M, Rosen PP. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001;92(6):1368–1377.

    Article  PubMed  CAS  Google Scholar 

  23. Poage E, Singer M, Armer J, Poundall M, Shellabarger MJ. Demystifying lymphedema: development of the lymphedema ­putting evidence into practice card. Clin J Oncol Nurs. 2008;12(6):951–964.

    Article  PubMed  Google Scholar 

  24. Armer JM, Stewart BR. A comparison of four diagnostic criteria for lymphedema in a post-breast cancer population. Lymphat Res Biol. 2005;3(4):208–217.

    Article  PubMed  Google Scholar 

  25. Taylor ME, Keleti D, Perez CA, et al. The effect of medical co-mordbidities of diabetes, hypertension and obesity on the incidence of arm edema after breast conservation therapy for stage I and II breast cancer patients. Int J Radiat Oncol Biol Phys 2000;48(Supplement):144.

    Article  Google Scholar 

  26. Schmitz KH, Ahmed RL, Troxel A, et al. Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med. 2009;361(7):664–673.

    Article  Google Scholar 

  27. Chachaj A, Malyszczak K, Pyszel K, et al. Physical and psychological impairments of women with upper limb lymphedema ­following breast cancer treatment. Psychooncology. 2009;19(3):299–305.

    Google Scholar 

  28. Hayes SC, Reul-Hirche H, Turner J. Exercise and secondary lymphedema: safety, potential benefits, and research issues. Med Sci Sports Exerc. 2009;41(3):483–489.

    Article  PubMed  Google Scholar 

  29. Mak SS, Mo KF, Suen JJ, Chan SL, Ma WL, Yeo W. Lymphedema and quality of life in Chinese women after treatment for breast cancer. Eur J Oncol Nurs. 2009;13(2):110–115.

    Article  PubMed  CAS  Google Scholar 

  30. Velanovich V, Szymanski W. Quality of life of breast cancer patients with lymphedema. Am J Surg. 1999;177(3):184–187; ­discussion 188.

    Article  PubMed  CAS  Google Scholar 

Helpful Resources

  1. The American Cancer Society http://www.cancer.org/docroot/MIT/content/MIT_7_2x_Understanding_Lymphedema.asp

  2. Lymphedema Resources http://www.lymphedemaresources.org/

  3. The National Lymphedema Network http://www.lymphnet.org

  4. The Lymphatic Research Foundation http://www.lymphaticresearch.org

  5. Fashionable Lymphedema Garments http://lymphedivas.com/

  6. Lymphedema People http://www.lymphedemapeople.com/

  7. Susan G. Komen Breast Cancer Foundation http://ww5.komen.org/

  8. Solaris Supplies http://www.solarismed.com/index.php

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Acknowledgments

The department of physical therapy at Fletcher Allen Health Care assisted in the patient photographs and the lymphedema-care summaries.

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Authors and Affiliations

  1. Department of Hematology and Oncology, University of Vermont College of Medicine, 89 Beaumont Ave., Burlington, VT, 05405, USA

    Andrea M. Steely

Authors
  1. Andrea M. Steely
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  2. Patricia O’Brien
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Corresponding author

Correspondence to Andrea M. Steely .

Editor information

Editors and Affiliations

  1. Clinical Professor, Cancer Coucil Australia, University of Sydney Medical School, Surry Hills, 2010, New South Wales, Australia

    Ian N. Olver

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© 2010 Society for Imaging Informatics in Medicine

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Steely, A.M., O’Brien, P. (2010). Lymphedema Care. In: Olver, I. (eds) The MASCC Textbook of Cancer Supportive Care and Survivorship. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1225-1_19

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  • DOI: https://doi.org/10.1007/978-1-4419-1225-1_19

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-1224-4

  • Online ISBN: 978-1-4419-1225-1

  • eBook Packages: MedicineMedicine (R0)

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