Abstract
The evidence available for risk reduction of lymphedema after breast cancer treatment is sparse and inconsistent. It is limited by confounding factors such as axillary disease burden, number of lymph nodes harvested, and radiation treatment. However, there are several strategies for prevention and risk reduction prior to the onset of lymphedema. Techniques such as sentinel lymph node biopsy, axillary reverse mapping, lymphatic anastomosis, and lymphovenular anastomosis are aimed at preventing or minimizing the disruption of lymphatic flow from the upper extremity. Few surgical procedures, such as the historical Charles procedure, as well as newer techniques including distal lymphaticovenular anastomosis, lymph node transfer, suction-assisted protein lipectomy, and low-level laser therapy exist. Nonsurgical treatments include complete decongestive therapy, pneumatic compression, Kinesio tape, and exercise. These have varying degrees of effectiveness but have limitations in patient compliance or availability of certified therapists.
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