Strategies to protect breast cancer patients from lymphedema

As part of a global effort to improve the lives of breast cancer survivors, new health research has examined strategies that can help prevent lymphedema in millions of cancer survivors following damage or loss. removal of their lymph nodes during cancer treatment.

According to the study published in eMedicineClinical.

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

Although there is currently no approach to completely prevent lymphedema, researchers from Hong Kong’s Princess Margaret Hospital, Flinders University and the University of Toronto collaborated with 64 global experts from 16 countries to develop guidelines that can effectively help prevent this disease after reviewing clinical trials. .

The study examined data from more than 60,000 patients with breast cancer-related arm lymphedema involved in high-quality randomized controlled studies to determine the best prevention strategies and risk factors that may cause this disease.

These risk factors include postoperative radiation therapy, failure to monitor 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. Effective treatment to prevent it and stop its progression is therefore essential.

“Like many breast cancer survivors, I received limited and conflicting information about lymphedema after cancer treatment, leaving me anxious and ill-equipped to manage my symptoms. This had a negative effect on me psychologically and physically and prevented me from returning to work. “

“This research raises awareness of this problem under recognized conditions and fills gaps in clinical understanding. It is a necessary step toward providing care that will lead to improved health outcomes for many breast cancer survivors in the world.”

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

“Our study revealed evidence-based approaches to preventing BCRAL through approaches that consider patient risk factors, availability of treatment options, and healthcare provider expertise to ensure that All patients are offered effective interventions, regardless of where they receive care.”

“This is the first study in the world to provide recommendations on the frequency and duration of monitoring, methods of early detection of lymphedema, thresholds for early intervention and the types of treatments to be offered depending on the degree of the disease. Armed with this knowledge, these interventions can now be applied with confidence in clinical settings.

Endorsed by the Multinational Cancer Supportive Care Association, experts support the rollout of monitoring programs that can help prevent lymphedema and have for the first time supported treatments using compression sleeves.

Compression sleeves are designed to provide controlled pressure that reduces arm swelling associated with patients undergoing treatment for breast cancer-related arm lymphedema.

The study’s lead author, Dr. Henry Wong, a clinical oncologist at the Oncology Department at Princess Margaret Hospital, Hong Kong, says the study is the first to provide a detailed guide on how to implement monitoring programs and prophylactic compression sleeves for BCRAL prevention.

“Our consensus recommendations generated by an international team of experts provide a strong voice for healthcare teams around the world to take a proactive approach to preventing this irreversible treatment-related complication.” »

Dr. Matthew Wallen, principal investigator at the Caring Futures Institute and co-first author, says the strength of this clinical practice guidance document lies in its robust multidisciplinary approach to preventing BCRAL.

“By identifying key risk factors, implementing early monitoring and providing recommendations on the latest treatment and management strategies, we can ensure that people living with BCRAL are offered practical care interventions, timely and evidence-based. »

“Our study highlights best practices in the management of BCRAL and offers hope and empowerment to breast cancer survivors who may be devastated by their lymphedema,” says Dr. Adrian Wai Chan, clinical researcher in the Department of Radiology. -oncology. Sunnybrook Health Sciences Centre, University of Toronto and co-first author.