Strategies to shield breast cancer patients from lymphedema

In In The News by Barbara Jacoby

By: Flinders University


n a global effort to improve the lives of breast cancer survivors, new health research has looked at strategies that can help prevent lymphedema for millions of cancer survivors as a result of damage or removal of their lymph nodes during cancer treatment.

Compression sleeves, surgery to repair patients’ lymphatic systems and axillary reverse mapping (ARM) should be offered to people at risk of developing breast cancer-related arm lymphedema (BCRAL), according to the study published in eClinicalMedicine.

Lymphedema is a distressing condition that involves the accumulation of fluid in patients’ arms, resulting from damage or removal of lymph nodes during breast . The global experts in this study have, for the first time, published a clinical guide on how and when to roll out evidence-based interventions.

While there is currently no approach that can completely prevent lymphedema, researchers from Princess Margaret Hospital in Hong Kong, Flinders University and the University of Toronto collaborated with 64 global experts from 16 countries to develop guidance that can effectively help prevent the condition after reviewing .

The study reviewed data from more than 60 thousand patients with breast cancer-related arm lymphedema involved in high-quality randomized-controlled studies to determine the best prevention strategies and risk factors that can cause the condition.

These risk factors include post-surgery radiotherapy, not monitoring patients arm volume one month after surgery, the number of lymph nodes removed, and a high body mass index.

Breast cancer survivor Monique Bareham says chronic lymphedema is irreversible, difficult to treat and significantly affects patients’ quality of life, so effective management to prevent it and halt its progression is critical.

“Like many breast cancer survivors, I received limited and conflicting information about lymphedema following cancer treatment, leaving me anxious and ill-equipped to manage my symptoms. It had a negative effect on me psychologically and physically and left me unable to return to work. ”

“This research raises awareness of this under recognized condition and addresses gaps in clinical understanding. It is a necessary step toward providing care that will lead to better health outcomes for many breast cancer survivors Worldwide.”

Deputy Vice-Chancellor (Research) at Flinders University and the study’s co-senior author, Professor Raymond Chan says about half of patients with breast cancer-related arm lymphedema (BCRAL) develop this condition 12–30 months after surgery, but it can also develop many years later.

“Our study has revealed evidence-based approaches to prevent BCRAL through approaches that take into account risk factors for patients, the availability of treatment options and the expertise of health care providers to ensure all patients are offered effective interventions, regardless of where they’re receiving care.”

“This is the first study in the world to provide recommendations on the frequency and duration of surveillance, methods to detect early lymphedema, thresholds for early intervention and types of treatments to offer depending on the degree of the condition. With this knowledge, these interventions can now be applied with confidence in clinical settings.”