Breast Cancer Related Lymphedema: An Interdisciplinary Approach.

Abstract

Many survivors of breast cancer complete their treatment, only to suffer from secondary lymphedema. Chemotherapy, radiotherapy, and surgically removing axillary lymph nodes all potentially disrupt upper limb lymphatic drainage, causing fluid accumulation in the upper extremity. The swelling and increased volume of the upper extremity due to fluid accumulation severely limits a patient’s ability to live normally and perform their activities of daily living. Healthcare providers have the responsibility to both educate patients about possible outcomes of cancer treatment as well as monitor subsequent changes. After breast cancer surgery, physicians and nurses have the opportunity to monitor the patient to closely track possible symptoms or risk factors for lymphedema. Nurses in particular spend significant time with patients, which provides them the ability to notice any abnormal changes in limb volume or movement. Additionally, their relationship with the patient allows nurses to properly educate and discuss the possibility of lymphedema. Physical and occupational therapists work with patients after surgery to increase strength, mobility, and a patient’s ability to perform activities of daily living. If lymphedema has been diagnosed, they also work to decrease arm volume and increase range of motion. Methods of managing lymphedema include medication, surgery, manual lymphatic drainage, compression, exercise, and bandaging. An interdisciplinary approach which includes these components while adjusting for patient preference will improve a patient’s chance of living an enjoyable, productive life while managing symptoms of lymphedema.