Breast Cancer Related Lymphedema: Pathogenesis,Incidence Rates, Diagnostic Techniques, Treatment Paradigms And Risk Reduction

With improved outcomes following treatment of breast cancer, breast cancer relatedlymphedema (BCRL) gain increased significance with limited evidence-based guidelinespresent. This review attempts to summarize data addressing these concerns and providesrecommendations based on currently published data. Substantial differences exist in ratesof BCRL reported in the literature ranging from less than0%to94%based on locoregionaltherapy, and the average incidence is20%. Based on recent data, early diagnosis of BCRLappears critical and there are differences at diagnostic methods and criteria for diagnosis ofresearch. Complex decongestive physiotherapy(CDP) and surgery can provide significantimprovement in patient symptoms and volume reduction of edematous extremities, butcannot effect a radical cure. We require careful attention to patient risk factors. Axillarylymph node dissection(ALND), radical mastectomy(RM) and body mass index(BMI) aresignificantly increased risk of the BCRL. At this time, consensus recommendations fordisease classification, diagnostic testing and treatment are still lacking. Awareness of thefrequency is now important as more accurate clinical aids have become accessible todiagnose the condition at an earlier stage allowing timely intervention providing theopportunity for treatment strategies to be more effective.