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Diagnostic Methods, Risk Factors, Prevention, and Management of Breast Cancer-Related Lymphedema: Past, Present, and Future Directions

  • Local-Regional Evaluation and Therapy (EP Mamounas, Section Editor)
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Abstract

Purpose of Review

Breast cancer-related lymphedema (BCRL) is a chronic, adverse, and much feared complication of breast cancer treatment, which affects approximately 20% of patients following breast cancer treatment. BCRL has a tremendous impact on breast cancer survivors, including physical impairments and significant psychological consequences. The intent of this review is to discuss recent studies and analyses regarding the risk factors, diagnosis, prevention through early screening and intervention, and management of BCRL.

Recent Findings

Highly-evidenced risk factors for BCRL include axillary lymph node dissection, lack of reconstruction, radiation to the lymph nodes, high BMI at diagnosis, weight fluctuations during and after treatment, subclinical edema within and beyond 3 months after surgery, and cellulitis in the at-risk arm. Avoidance of potential risk factors can serve as a method of prevention. Through establishing a screening program by which breast cancer patients are measured pre-operatively and at follow-ups, are objectively assessed through a weight-adjusted analysis, and are clinically assessed for signs and symptoms, BCRL can be tracked accurately and treated effectively. Management of BCRL is done by a trained professional, with research mounting towards the use of compression bandaging as a first line intervention against BCRL. Finally, exercise is safe for breast cancer patients with and without BCRL and does not incite or exacerbate symptoms of BCRL.

Summary

Recent research has shed light on BCRL risk factors, diagnosis, prevention, and management. We hope that education on these aspects of BCRL will promote an informed, consistent approach and encourage additional research in this field to improve patient outcomes and quality of life in breast cancer survivors.

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Acknowledgements

The project was supported by Award Number R01CA139118 (AGT) and Award Number P50CA08393 (AGT) from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. This program is supported by the Adele McKinnon Research Fund for Breast Cancer-Related Lymphedema.

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Authors and Affiliations

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

    Hoda E. Sayegh, Maria S. Asdourian, Meyha N. Swaroop, Melissa N. Skolny, Laura Salama & Alphonse G. Taghian

  2. Department of Physical Therapy, Massachusetts General Hospital, Boston, MA, USA

    Cheryl L. Brunelle

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  1. Hoda E. Sayegh
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  2. Maria S. Asdourian
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  3. Meyha N. Swaroop
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  4. Cheryl L. Brunelle
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  5. Melissa N. Skolny
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  6. Laura Salama
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  7. Alphonse G. Taghian
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Correspondence to Alphonse G. Taghian.

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Conflict of Interest

Hoda Sayegh, Maria Asdourian, Meyha Swaroop, Cheryl Brunelle, Melissa Skolny, and Laura Salama declare no conflict of interest.

Alphonse G. Taghian is supported by the National Cancer Institute and has served as a consultant for VisionRT.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Local-Regional Evaluation and Therapy

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Sayegh, H.E., Asdourian, M.S., Swaroop, M.N. et al. Diagnostic Methods, Risk Factors, Prevention, and Management of Breast Cancer-Related Lymphedema: Past, Present, and Future Directions. Curr Breast Cancer Rep 9, 111–121 (2017). https://doi.org/10.1007/s12609-017-0237-8

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