Lymphedema of breast cancer: risk factor and treatment

Abstract

One of the well-known complication of breast cancer treatment is secondary lymphedema; an accumulation of protein-rich interstitial fluid due to the insufficient capacity of the lymphatic system. Lymphedema are affects about 20-30% of women following breast cancer treatment and the risk factors associated with lymphedema development after breast cancer surgery and or radiotherapy are not well established. Early diagnosis and treatment is considered important for successful management of breast cancer related arm lymphoedema. The objective of this study is to assess the value of risk factor and treatment modality of lymphedema. Electronic searches were conducted in MEDLINE®, EMBASE, CINAHL®, and Social Sciences Citation Index. Articles were included where researchers used qualitative research methods and when a comprehensive description of methods and the study's findings were provided. Among 1210 articles, 30-37% developed lymphedema and 45% associated with incresead body mass index (BMI), 53% related with higher stage of disease. Furthermore; 74% strongly step rise with the number of involved lymph nodes; 41% in comorbid diseases, and the time after surgery showed significant correlation with the development of lymphedema in 32%. Suction-assisted protein lipectomy (SAPL) has been shown to safely and effectively reduce the solid component of swelling in chronic lymphedema and microsurgery procedures, including lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), have been shown to be effective in the management of the fluid component of lymphedema and allow for decreased garment use.