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Lymphedema Following Breast Cancer: Regions Affected, Severity of Symptoms, and Benefits of Treatment From the Patients' Perspective

Robyn Sierla
Teresa Sze Mun Lee
Deborah Black
Sharon Lynn Kilbreath
CJON 2013, 17(3), 325-331 DOI: 10.1188/13.CJON.325-331

Limited high-quality research has focused on the efficacy of lymphedema treatments and symptomatic relief. With that in mind, the authors conducted a cross-sectional survey to describe the presentation of breast cancer-related lymphedema, treatment modalities used, and perceived effectiveness. An electronic validated questionnaire to assess the presentation of lymphedema, severity of swelling and discomfort, number of modalities tried, and the benefits gained from treatment was completed by the Review and Survey Group of the Breast Cancer Network of Australia. Thirty-five percent of participants reported the presence of lymphedema, a majority of which reported it to be mild or moderate for magnitude of swelling and for discomfort. The correlation was weak between magnitude of swelling and discomfort. Compression, massage, and exercise were the most commonly used modalities in these patients. Notably, chest wall or breast lymphedema—about which research is lacking—was as common as hand lymphedema. Women experienced discomfort and physical changes, although the severity of the two was not related. Some benefit was reported for all modalities, but no particular modality was considered extremely helpful. Oncology nurses are ideally positioned to monitor women for early signs of swelling and to advise women on the range of treatments available.


Badger, C., Preston, N., Seers, K., & Mortimer, P. (2004). Physical therapies for reducing and controlling lymphoedema of the limbs. <i>Cochrane Database of Systematic Reviews, 4</i>, CD003141.

Czerniec, S. A., Ward, L. C., Lee, M. J., Refshauge, K. M., Beith, J., & Kilbreath, S. L. (2011). Segmental measurement of breast cancer-related arm lymphoedema using perometry and bioimpedance spectroscopy. <i>Supportive Care in Cancer, 19</i>, 703-710. doi:10.1007/s00520-010-0896-8

Czerniec, S. A., Ward, L. C., Refshauge, K. M., Beith, J., Lee, M. J., York, S., & Kilbreath, S. L. (2010). Assessment of breast cancer-related arm lymphedema—Comparison of physical measurement methods and self-report. <i>Cancer Investigation, 28</i>, 54-62. doi:10.3109/07357900902918494

Degnim, A. C., Miller, J., Hoskin, T. L., Boughey, J. C., Loprinzi, M., Thomsen, K., … Cheville, A. L. (2012). A prospective study of breast lymphedema: Frequency, symptoms, and quality of life. <i>Breast Cancer Research and Treatment, 134</i>, 915-922. doi:10.1007/s10549-012-2004-x

Devoogdt, N., Christiaens, M. R., Geraerts, I., Truijen, S., Smeets, A., Leunen, K., … Van Kampen, M. (2011). Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphoedema related to breast cancer: Randomised controlled trial. <i>BMJ, 343</i>, d5326. doi:10.1136/bmj.d5326

Girgis, A., Stacey, F., Lee, T., Black, D., & Kilbreath, S. (2011). Priorities for women with lymphoedema after treatment for breast cancer: Population based cohort study. <i>BMJ, 342</i>, d3442. doi:10.1136/bmj.d3442

Hayes, S. C. (2008). <i>Review of research evidence on secondary lymphoedema: Incidence, prevention, risk factors, and treatment.</i> Retrieved from <a target="_blank" href='http://canceraustralia.gov.au/publications-resources/cancer-australia-pu...

Hayes, S. C., Reul-Hirche, H., & Turner, J. (2009). Exercise and secondary lymphedema: Safety, potential benefits, and research issues. <i>Medicine and Science in Sports and Exercise, 41</i>, 483-489. doi:10.1249/MSS.0b013e31818b98fb

International Consensus. (2006). Best practice for the management of lymphoedema. Retrieved from <a target="_blank" href='http://www.woundsinternational.com/clinical-guidelines/best-practice-for...

International Society of Lymphology. (2009). The diagnosis and treatment of peripheral lymphedema. 2009 Concensus Document of the International Society of Lymphology. <i>Lymphology, 42</i>, 51-60.

Jahr, S., Schoppe, B., & Reisshauer, A. (2008). Effect of treatment with low-intensity and extremely low-frequency electrostatic fields (deep oscillation) on breast tissue and pain in patients with secondary breast lymphedema. <i>Journal of Rehabilitation Medicine, 40</i>, 645-650. doi:10.2340/16501977-0225

Jensen, M. R., Simonsen, L., Karlsmark, T., & Bulow, J. (2010). Lymphedema of the lower extremities—Background, pathophysiology, and diagnostic considerations. <i>Clinical Physiology and Functional Imaging, 30</i>, 389-398. doi:10.1111/j.1475-097X.2010.00969.x

Karki, A., Anttila, H., Tasmuth, T., & Rautakorpi, U. M. (2009). Lymphedema therapy in breast cancer patients—A systematic review on effectiveness and a survey of current practices and costs in Finland. <i>Acta Oncologica, 48</i>, 850-859.

Lymphedema Framework. (2006). Template for practice: Compression hosiery in lymphedema. Retrieved from <a target="_blank" href='http://www.woundsinternational.com/clinical-guidelines/template-for-prac...

Martin, M. L., Hernandez, M. A., Avendano, C., Rodriguez, F., & Martinez, H. (2011). Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema. <i>BMC Cancer, 11</i>, 94-99.

McNeely, M. L., Peddle, C. J., Yurick, J. L., Dayes, I. S., & Mackey, J. R. (2011). Conservative and dietary interventions for cancer-related lymphedema: A systematic review and meta-analysis. <i>Cancer, 117</i>, 1136-1148. doi:10.1002/cncr.25513

Moseley, A. L., Carati, C. J., & Piller, N. B. (2007). A systematic review of common conservative therapies for arm lymphedema secondary to breast cancer treatment. <i>Annals of Oncology, 18</i>, 639-646. doi:10.1093/annonc/mdl182

Norman, S. A., Localio, A. R., Potashnik, S. L., Simoes Torpey, H. A., Kallan, M. J., Weber, A. L., … Solin, L. J. (2009). Lymphedema in breast cancer survivors: Incidence, degree, time course, treatment, and symptoms. <i>Journal of Clinical Oncology, 27</i>, 390-397. doi:10.1200/JCO.2008.17.9291

Norman, S. A., Miller, L. T., Erikson, H. B., Norman, M. F., & McCorkle, R. (2001). Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer. <i>Physical Therapy, 81</i>, 1192-1205.

Ridner, S. H., Montgomery, L. D., Hepworth, J. T., Stewart, B. R., & Armer, J. M. (2007). Comparison of upper limb volume measurement techniques and arm symptoms between healthy volunteers and individuals with known lymphedema. <i>Lymphology, 40</i>, 35-46.

Suami, H., Taylor, G. I., & Pan, W. R. (2007). The lymphatic territories of the upper limb: Anatomical study and clinical implications. <i>Plastic and Reconstructive Surgery, 119</i>, 1813-1822. doi:10.1097/01.prs.0000246516.64780.61

Torres Lacomba, M., Yuste Sánchez, M. J., Zapico Goñi, A., Prieto Merino, D., Mayoral del Moral, O., Cerezo Téllez, E., & Minayo Mogollón, E. (2010). Effectiveness of early physiotherapy to prevent lymphedema after surgery for breast cancer: Randomised, single blinded, clinical trial. <i>BMJ, 340</i>, b5396.

Tunney, G. (2006). <i>Educational attainment in Australia. Economic Roundup.</i> Retrieved from <a target="_blank" href='http://epsa.treasury.gov.au/documents/1107/PDF/01Educational.pdf'>http:/...