LATEST GUIDELINES REGARDING LYMPHEDEMA RISK
Currently, about 1 in 5 people living with breast cancer will develop breast cancer related lymphedema (BRCL). Lymphedema often has a negative effect on individual’s lifestyles, contributing to loss of movement, decreased activity, diminished body image, heaviness, and pain. A list of risk reduction practices was published many years ago to help people manage the disease and was widely accepted although there was limited evidence to support the recommendations. While the guidelines sought to minimize the burden of lymphedema, in many cases these guidelines increased the burden without the intended benefits. To be fair, they were published when lymphedema was poorly understood, very few clinicians were able to effectively treat it, and patients had little to no access to proper care. It was all we had.
The understanding of lymphedema and its management strategies have progressed since then, and more studies regarding lymphedema have been published. A recent literature review by Gillespie, et al (see link below to access the free article) discusses current evidence regarding risks of developing BRCL. The results may be surprising and are definitely welcome. While more research needs to be done, this review highlights some of the findings in various studies. I have summarized some of the key findings of these studies here:
The main thing to remember is that lymphedema is a complex disorder, affecting each individual differently, and thus requiring a more targeted approach to management. More treatment and long-term care options are available to patients now than ever before. The therapists at Forté are dedicated to helping our patients manage their lymphedema based on current recommendations. We offer guidance tailored to each person’s specific needs, considering their unique lifestyles, abilities, risk preferences, and severity of the condition.
Currently, about 1 in 5 people living with breast cancer will develop breast cancer related lymphedema (BRCL). Lymphedema often has a negative effect on individual’s lifestyles, contributing to loss of movement, decreased activity, diminished body image, heaviness, and pain. A list of risk reduction practices was published many years ago to help people manage the disease and was widely accepted although there was limited evidence to support the recommendations. While the guidelines sought to minimize the burden of lymphedema, in many cases these guidelines increased the burden without the intended benefits. To be fair, they were published when lymphedema was poorly understood, very few clinicians were able to effectively treat it, and patients had little to no access to proper care. It was all we had.
The understanding of lymphedema and its management strategies have progressed since then, and more studies regarding lymphedema have been published. A recent literature review by Gillespie, et al (see link below to access the free article) discusses current evidence regarding risks of developing BRCL. The results may be surprising and are definitely welcome. While more research needs to be done, this review highlights some of the findings in various studies. I have summarized some of the key findings of these studies here:
- The greatest risk factors for BRCL is the removal of lymph nodes in the armpit; and radiation to the armpit where lymph nodes are located.
- Those with 10 or more axillary lymph nodes removed have a higher risk of developing lymphedema (27%), than those with less than 10 axillary lymph nodes removed (7%).
- Patients who receive radiation to the armpit in lieu of removal of lymph nodes have lower rates of clinically diagnosed lymphedema 5 years after surgery (23% vs. 11%)
- Patients with a BMI of 30 kg/m2 or above were 3.6 times more likely to develop lymphedema
- Blood pressure readings, blood draws, and air travel has not shown to significantly increase BCRL risk in patients who undergo unilateral breast cancer surgery
- An exercise program including both aerobic and resistance exercises does not incite or exacerbate BRCL
The main thing to remember is that lymphedema is a complex disorder, affecting each individual differently, and thus requiring a more targeted approach to management. More treatment and long-term care options are available to patients now than ever before. The therapists at Forté are dedicated to helping our patients manage their lymphedema based on current recommendations. We offer guidance tailored to each person’s specific needs, considering their unique lifestyles, abilities, risk preferences, and severity of the condition.