Leung, N., Furniss, D., & Giele, H. (2015). Modern surgical management of breast cancer therapy related upper limb and breast lymphoedema. Maturitas, 80, 384–390. 

DOI Link

Purpose

STUDY PURPOSE: To consider the risks, benefits, and efficacy of current techniques in preventing or managing upper extremity lymphedema related to breast cancer surgery and to bring focus to more specific research gaps for additional investigation
 
TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: MEDLINE
 
KEYWORDS: Lymphatic vessels, lymphedema, and surgery (related to these)
 
INCLUSION CRITERIA: Published after 2000; only modern surgical techniques; prevention or treatment
 
EXCLUSION CRITERIA: Studies not meeting the criteria for inclusion

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 20,614
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: A literature search of MEDLINE from its start to February 2014 was completed. The studies included had to be published after 2000 and either prevent or treat lymphedema secondary to breast cancer treatment. The studies' references also were reviewed for inclusion.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 16
  • TOTAL PATIENTS INCLUDED IN REVIEW = 305 
  • KEY SAMPLE CHARACTERISTICS: Breast cancer patients only; patients with and without lymphedema

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care
 
APPLICATIONS: Palliative care

Results

The most useful procedure out of those reviewed was lymphatic vessel anastomosis. The least recommended was lymph node transfer because of conflicting data and potential complications. The remaining reviewed options would be effective based on individual cases and needs.

Conclusions

  1. More research on lymphatic vessel anastomosis determining the ideal population and parameters for its use is needed.
  2. Better definitions of outcomes and a more specific focus for research and data interpretation are needed.
  3. Standards for the diagnosis and treatment of lymphedema must be improved to identify current and potential patients who may need interventions or prevention.

Limitations

  • No noted method to evaluate the quality of the studies being reviewed

Nursing Implications

The findings of this systematic review showed that initiatives to do primary research and data collection would be useful. This may be an area in which nurses can contribute.

Legacy ID

5497