Breast Cancer-Related Lymphedema: a Review of Risk Factors, Radiation Therapy Contribution, and Management Strategies

Abstract

In recent years, breast cancer-related lymphedema (BCRL), which affects one in five patients treated for breast cancer (BC), has garnered increasing interest by clinicians and researchers as BC survival rates improve and survivorship issues become increasingly imperative. This review represents an overview of the literature for BCRL risk factors, such as radiation therapy (RT), screening, and treatment. Risk factors with strong evidence include axillary surgery, regional lymph node radiation, elevated body mass index, cellulitis, and subclinical edema. Neoadjuvant and taxane-based chemotherapy, trastuzumab, breast reconstruction, RT field design, and genetic susceptibility are emerging as potentially influencing BCRL risk. Comprehensive BCRL care necessitates a multidisciplinary team that coordinates BC treatment, educates patients, and vigilantly screens them throughout survivorship. Providers should be knowledgeable of BCRL risk factors and individualize patient education. Universal diagnostic criteria using relative change from baseline and consistently incorporating baseline measurements are imperative.