Breast Cancer-Related Lymphedema: Recent Updates on Diagnosis, Severity and Available Treatments

Breast cancer-related lymphedema (BCRL) represents a global healthcare issue affecting the emotional and life quality of breast cancer survivors significantly. The clinical presentation is characterized by swelling of the affected upper limb, that may be accompanied by atrophic skin findings, pain and recurrent cellulitis. Cardinal principles of lymphedema management are the use of complex decongestive therapy and patient education. Recently, new microsurgery procedures have been reported with interesting results, bringing in a new opportunity to care postmastectomy lymphedema. However, many aspects of the disease are still debated in the medical community, including clinical examination, imaging techniques, patient selection and proper treatment. Here we will review these aspects and the current literature.

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The Quality of Life in Long-Term Breast Cancer Survivors with Breast Cancer Related Lymphedema

Acta Chirurgica Belgica ◽

10.1080/00015458.2014.11681019 ◽

2014 ◽

Vol 114 (4) ◽

pp. 239-244 ◽

Cited By ~ 9

Author(s):

T. R. Lopez Penha ◽

J. van Bodegraven ◽

B. Winkens ◽

E. M. Heuts ◽

A. C. Voogdi ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Breast Cancer Related Lymphedema

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Effect of patient education on quality-of-life, pain and fatigue in breast cancer survivors: A systematic review and meta-analysis

Clinical Rehabilitation ◽

10.1177/02692155211031081 ◽

2021 ◽

pp. 026921552110310

Author(s):

Patricia Martínez-Miranda ◽

Maria Jesús Casuso-Holgado ◽

José Jesús Jiménez-Rejano

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Patient Education ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Short Term ◽

Emotional Quality ◽

Global Quality ◽

Global Quality Of Life

Objective: To synthesise the existing evidence about the effect of patient education, either used alone or as adjunctive therapy, on the improvement of quality of life, pain and fatigue in adult breast cancer survivors. Data sources: We searched PubMed, Web of Science, CINAHL, SCOPUS, Cochrane Plus, PEDro, Dialnet and Clinicaltrials.gov databases. Methods: We conducted this systematic review in accordance with the PRISMA statement. Only randomised controlled trials with adult breast cancer survivors were included. We assessed the methodological quality of the studies using the PEDro scale and the Cochrane risk-of-bias tool. We synthesised evidence using the GRADE tool. Results: We included 14 studies (PEDro 4–8 points) comprising 1749 adult women who survived breast cancer, of which we included 12 in the quantitative analysis. There were statistically significant short-term benefits for improved global quality-of-life (standardised mean difference [SMD] = 0.43, P = 0.05, 95% CI [0.00, 0.85]; GRADE: low certainty; not important), emotional quality-of-life (SMD = 0.32, P = 0.04, 95% CI [0.02, 0.62]) and fatigue (SMD = 0.24, P = 0.0004, 95% CI [0.11, 0.37]; GRADE: low certainty; not important). However, there were not statistically significant for pain severity (SMD = −0.05, P = 0.67, 95% CI [−0.26, 0.17]; GRADE: low certainty; not important) and fear to recurrence (SMD = −0.05, P = 0.68, 95% CI [−0.31, 0.20]; GRADE: moderate certainty; not important). Conclusion: Patient education have a significative effect in short-term global quality-of-life, emotional quality-of-life and fatigue, though all the results were classified as ‘not important’.

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Patient education, upper-limb symptom perception, and quality of life among Japanese breast cancer survivors

Quality of Life Research ◽

10.1007/s11136-014-0680-1 ◽

2014 ◽

Vol 23 (8) ◽

pp. 2327-2332 ◽

Cited By ~ 5

Author(s):

Miyako Tsuchiya

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Patient Education ◽

Cancer Survivors ◽

Upper Limb ◽

Breast Cancer Survivors ◽

Symptom Perception

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Risk factors and management of breast cancer-related lymphedema

International Journal of Medicine ◽

10.14419/ijm.v3i1.4471 ◽

2015 ◽

Vol 3 (1) ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Awad Alawad ◽

Ayat Omer Ibrahim

Keyword(s):

Breast Cancer ◽

Clinical Presentation ◽

Breast Cancer Therapy ◽

Arm Pain ◽

Arm Swelling ◽

Arm Lymphedema ◽

Breast Cancer Related Lymphedema ◽

Undergo Breast Reconstruction ◽

Morbid Conditions

Background: Lymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life.Objective: The aim of this study was to identify the clinical presentation of lymphedema associated factors in women treated for breast cancer.Methods:The study is an interventional prospective study. It was accomplished in the period from May 2013 to April 2014. Patients having breast cancer ipsilateral arm lymphedema were selected for the study.Results: A total of 34 patients were included in the study.73.5% of patients have a body mass index (BMI) of 25 or more at diagnosis. 70.6% of the patients underwent axillary clearance. All the patients did not undergo breast reconstruction. 52.4% had <10 lymph nodes removed from their axillae. 47% received radiotherapy. All patients presented with arm swelling, additionally, 70.6 % presented with arm heaviness 26.5% presented with arm pain. Elevation was effective in 90.5% of the compliant patients, while exercise was effective in 84.2% of the compliant patients.Conclusion: Breast cancer- related lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection axillary radiation should be avoided whenever feasible to avoid lymphedema.

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