Smile, T.D., Tendulkar, R., Schwarz, G., Arthur, D., Grobmyer, S., Valente, S., . . . Shah, C. (2016). A review of treatment for breast cancer-related lymphedema: Paradigms for clinical practice. American Journal of Clinical Oncology. Advance online publication.
DOI Link
Purpose
STUDY PURPOSE: To evaluate breast cancer–related lymphedema treatment options to provide guidance to clinicians
TYPE OF STUDY: Systematic review
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 45
- TOTAL PATIENTS INCLUDED IN REVIEW = 1,838: 758 for CDT, 383 for MLD and compression, and 597 for invasive procedures
- SAMPLE RANGE ACROSS STUDIES: 2–139
- KEY SAMPLE CHARACTERISTICS: All had breast cancer.
Phase of Care and Clinical Applications
PHASE OF CARE: Late effects and survivorship
Results
- CDT: Studies showed a consistent finding of volume reduction.
- MLD: 12 studies reported MLD with or without compression. The role of MLD as a single intervention is limited—it may have benefit incorporated into CDT.
- Compression: Seven studies showed that compression was associated with consistent volume reduction. Kinesio taping was included with bandaging and intermittent pneumatic compression.
- Invasive treatments: There were few studies of liposuction. Surgical interventions such as lymphatic bypass and node transplantation were associated with complications.
Conclusions
CDT is the most studied and consistently beneficial intervention.
Limitations
- Limited search
- Limited number of studies included
- No quality evaluation
- Mostly low quality/high risk of bias studies
- Low sample sizes
- Very limited number of studies and only one database used
Nursing Implications
This review adds to the body of evidence showing that the use of compression bandaging and CDT are shown to be effective for managing breast cancer–related lymphedema. Nurses can recommend these interventions. Additional research is needed in the area of invasive interventions.