Annals of Surgical Oncology

, Volume 24, Issue 10, pp 2818–2826 | Cite as

Considerations for Clinicians in the Diagnosis, Prevention, and Treatment of Breast Cancer-Related Lymphedema: Recommendations from a Multidisciplinary Expert ASBrS Panel

Part 1: Definitions, Assessments, Education, and Future Directions
  • Sarah A. McLaughlinEmail author
  • Alicia C. Staley
  • Frank Vicini
  • Paul Thiruchelvam
  • Nancy A. Hutchison
  • Jane Mendez
  • Fiona MacNeill
  • Stanley G. Rockson
  • Sarah M. DeSnyder
  • Suzanne Klimberg
  • Michael Alatriste
  • Francesco Boccardo
  • Mark L. Smith
  • Sheldon M. Feldman
Breast Oncology

Lymphedema is a chronic, debilitating disease defined as an abnormal, generalized, or regional accumulation of protein-rich interstitial fluid resulting in edema formation and change in tissue structure. Lymphedema reflects the “relative” imbalance between the rate of interstitial fluid generation (lymphatic load) and the degree to which the lymphatic vasculature (lymphatic transport capacity) is underdeveloped or damaged.1

Breast cancer-related lymphedema (BCRL) is a common but underreported complication of breast cancer treatment because few studies have baseline and follow-up measurements or long-term (>5 year) follow-up evaluation adequate to record the incidence accurately. Furthermore, lymphedema has negative impact on overall quality of life and represents a financial burden for patients, caregivers, and society.2, 3, 4

Recent prospective randomized trials continue to document the incidence of lymphedema after any axillary treatment (Table  1). This risk increases after...



This work was funded via an unrestricted educational Grant from ImpediMed.


Frank Vicini is a research adviser for ImpediMed. Sarah A. McLaughlin, Alicia C. Staley, Paul Thiruchelvam, Nancy A. Hutchison, Jane Mendez, Fiona MacNeill, Stanley G. Rockson, Sarah M. DeSnyder, Suzanne Klimberg, Michael Alatriste, Francesco Boccardo, Mark L Smith, and Sheldon M. Feldman have no conflicts of interest to report.

Supplementary material

10434_2017_5982_MOESM1_ESM.docx (61 kb)
Supplementary material 1 (DOCX 61 kb)


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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Sarah A. McLaughlin
    • 1
    Email author
  • Alicia C. Staley
    • 2
  • Frank Vicini
    • 3
  • Paul Thiruchelvam
    • 4
  • Nancy A. Hutchison
    • 5
  • Jane Mendez
    • 6
  • Fiona MacNeill
    • 7
  • Stanley G. Rockson
    • 8
  • Sarah M. DeSnyder
    • 9
  • Suzanne Klimberg
    • 10
  • Michael Alatriste
    • 11
  • Francesco Boccardo
    • 12
  • Mark L. Smith
    • 13
  • Sheldon M. Feldman
    • 14
  1. 1.Department of SurgeryMayo ClinicJacksonvilleUSA
  2. 2.Patient AdvocateAkari HealthBostonUSA
  3. 3.Radiation OncologyUCLA School of MedicineLos AngelesUSA
  4. 4.Imperial College HealthcareLondonUK
  5. 5.Courage Kenny Rehabilitation Institute of AllinaHealthMinneapolisUSA
  6. 6.Miami Cancer InstituteMiamiUSA
  7. 7.Association of Breast Surgery Great Britain and IrelandRoyal College of Surgeons of EnglandLondonUK
  8. 8.Center for Lymphatic and Venous DisordersStanford University School of MedicineStanfordUSA
  9. 9.Department of Breast Surgical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  10. 10.Winthrop P. Rockefeller Cancer InstituteLittle RockUSA
  11. 11.Lymphedema Alliance of New YorkNew YorkUSA
  12. 12.Department of Surgery, Unit of Lymphatic Surgery - S. Martino University HospitalUniversity of GenoaGenoaItaly
  13. 13.Hofstra Northwell School of MedicineNorthwell Health Cancer InstituteLake SuccessUSA
  14. 14.Division of Breast Surgery and Breast Surgical Oncology, Department of Surgery, Montefiore Medical CenterThe University Hospital for the Albert Einstein College of MedicineNew YorkUSA

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