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Published online: 2024-10-25

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Are post-operative preventative measures effective in breast cancer-related lymphedema? A systematic review

Preksha Vivekanandan1, Molly Hashmi-Greenwood1, Adebayo Omileye2, Tadesse Gebrye1, Francis Fatoye1, Chidozie Emmanuel Mbada1
DOI: 10.5603/pmp.101961

Abstract

Breast cancer-related lymphedema (BCRL) is one of the most debilitating complications of breast cancer therapy. Many of the current approaches to preventing BRCL are based solely on anecdotes and insufficient evidence. This systematic review aimed to determine the effectiveness of post-operative BCRL preventive measures. The preferred reporting items for systematic reviews and meta-analysis guidelines were used in this review. Four databases (EBSCO CINAHL, EBSCO MEDLINE, EBSCO AMED, and Cochrane) were searched from 2012 to 2021. Studies were screened following preset inclusion and exclusion criteria. Joanna Briggs Institute (JBI) checklist and the Oxford Centre for Evidence-Based Medicine Hierarchy of Evidence (OCEBM) were used to critically appraise and evaluate the level of evidence of eligible studies. Out of the 470 articles screened, 29 were eligible for review. The articles were classified into six categories based on risk behaviors. Venipuncture, blood pressure measurements, and air travel had no strong evidence to be correlated with remission or exacerbation of BCRL (p > 0.05). There was a strong correlation between obesity and exacerbation or onset of lymphedema (p < 0.05). Physical activity and resistance training had high-quality evidence in preventing BCRL. Most studies were of moderate evidence level. There is limited evidence for post-operative precautions — like venipuncture, air travel, blood pressure measurements, and lifting heavy loads as risk factors for BCRL in patients with breast cancer. Empirical information regarding post-operative suggestions given to patients with BCRL will help to limit potentially harmful practices and enhance psychosocial health.

Keywords: breast cancerlymphedemarisk factorsprecautionsguidelines

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References

  1. Key Cancer Data and Key Figures on IARC: 2020–2021. https://www.iarc.who.int/biennial-report-2020-2021web/ (21.03.2022).
  2. Anastasiadi Z, Lianos GD, Ignatiadou E, et al. Breast cancer in young women: an overview. Updates Surg. 2017; 69(3): 313–317.
    CrossRefPubMed
  3. Sitlinger A, Zafar SY. Health-Related quality of life: the impact on morbidity and mortality. Surg Oncol Clin N Am. 2018; 27(4): 675–684.
    CrossRefPubMed
  4. Carreira H, Williams R, Dempsey H, et al. Quality of life and mental health in breast cancer survivors compared with non-cancer controls: a study of patient-reported outcomes in the United Kingdom. J Cancer Surviv. 2021; 15(4): 564–575.
    CrossRefPubMed
  5. Wang K, Yee C, Tam S, et al. Prevalence of pain in patients with breast cancer post-treatment: a systematic review. Breast. 2018; 42: 113–127.
    CrossRefPubMed
  6. Lovelace DL, McDaniel LR, Golden D. Long-Term effects of breast cancer surgery, treatment, and survivor care. J Midwifery Womens Health. 2019; 64(6): 713–724.
    CrossRefPubMed
  7. Bjerkeset E, Röhrl K, Schou-Bredal I. Symptom cluster of pain, fatigue, and psychological distress in breast cancer survivors: prevalence and characteristics. Breast Cancer Res Treat. 2020; 180(1): 63–71.
    CrossRefPubMed
  8. El-Tamer MB, Ward BM, Schifftner T, et al. Morbidity and mortality following breast cancer surgery in women: national benchmarks for standards of care. Ann Surg. 2007; 245(5): 665–671.
    CrossRefPubMed
  9. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002; 347(16): 1227–1232.
    CrossRefPubMed
  10. Azamjah N, Soltan-Zadeh Y, Zayeri F. Global trend of breast cancer mortality rate: a 25-year study. Asian Pac J Cancer Prev. 2019; 20(7): 2015–2020.
    CrossRefPubMed
  11. Coughlin SS. Social determinants of breast cancer risk, stage, and survival. Breast Cancer Res Treat. 2019; 177(3): 537–548.
    CrossRefPubMed
  12. Angarita FA, Acuna SA, Torregrosa L, et al. Perioperative variables associated with surgical site infection in breast cancer surgery. J Hosp Infect. 2011; 79(4): 328–332.
    CrossRefPubMed
  13. Ribeiro Pereira ACP, Koifman RJ, Bergmann A. Incidence and risk factors of lymphedema after breast cancer treatment: 10 years of follow-up. Breast. 2017; 36: 67–73.
    CrossRefPubMed
  14. Woodworth P, Mcboyle M, Helmer S, et al. Seroma formation after breast cancer surgery: incidence and predicting factors. Am Surg. 2022; 66(5): 444–450; discussion 450–451.
    CrossRef
  15. Wang Li, Guyatt GH, Kennedy SA, et al. Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies. CMAJ. 2016; 188(14): E352–E361.
    CrossRefPubMed
  16. Norman SA, Localio AR, Potashnik SL, et al. Lymphedema in breast cancer survivors: incidence, degree, time course, treatment, and symptoms. J Clin Oncol. 2009; 27(3): 390–397.
    CrossRefPubMed
  17. Penha TR, Botter B, Heuts EM, et al. Quality of life in patients with breast cancer-related lymphedema and reconstructive breast surgery. J Reconstr Microsurg. 2016; 32(6): 484–490.
    CrossRefPubMed
  18. McLaughlin SA, Brunelle CL, Taghian A. Breast cancer-related lymphedema: risk factors, screening, management, and the impact of locoregional treatment. J Clin Oncol. 2020; 38(20): 2341–2350.
    CrossRefPubMed
  19. Sung C, Wang S, Hsu J, et al. Current understanding of pathological mechanisms of lymphedema. Adv Wound Care (New Rochelle). 2022; 11(7): 361–373.
    CrossRefPubMed
  20. Paskett ED. Symptoms: lymphedema. Adv Exp Med Biol. 2015; 862: 101–113.
    CrossRefPubMed
  21. Svensson BJ, Dylke ES, Ward LC, et al. Screening for breast cancer-related lymphoedema: self-assessment of symptoms and signs. Support Care Cancer. 2020; 28(7): 3073–3080.
    CrossRefPubMed
  22. Denlinger CS, Sanft T, Baker KS, et al. Survivorship, version 2.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2018; 16(10): 1216–1247.
    CrossRefPubMed
  23. Jørgensen MG, Toyserkani NM, Hansen FG, et al. The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment. NPJ Breast Cancer. 2021; 7(1): 70.
    CrossRefPubMed
  24. Tsuchiya M, Takahashi M. Psychosocial impact of lymphoedema after breast surgery. Current Breast Cancer Reports. 2016; 8(1): 47–51.
    CrossRef
  25. Fu MR, Rosedale M. Breast cancer survivors' experiences of lymphedema-related symptoms. J Pain Symptom Manage. 2009; 38(6): 849–859.
    CrossRefPubMed
  26. Clough-Gorr KM, Ganz PA, Silliman RA. Older breast cancer survivors: factors associated with self-reported symptoms of persistent lymphedema over 7 years of follow-up. Breast J. 2010; 16(2): 147–155.
    CrossRefPubMed
  27. Goldberg JI, Wiechmann LI, Riedel ER, et al. Morbidity of sentinel node biopsy in breast cancer: the relationship between the number of excised lymph nodes and lymphedema. Ann Surg Oncol. 2010; 17(12): 3278–3286.
    CrossRefPubMed
  28. Toyserkani NM, Jørgensen MG, Haugaard K, et al. Seroma indicates increased risk of lymphedema following breast cancer treatment: A retrospective cohort study. Breast. 2017; 32: 102–104.
    CrossRefPubMed
  29. Togawa K, Ma H, Sullivan-Halley J, et al. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study. Breast Cancer Res. 2014; 16(4): 414.
    CrossRefPubMed
  30. Johansson K, Branje E. Arm lymphoedema in a cohort of breast cancer survivors 10 years after diagnosis. Acta Oncol. 2010; 49(2): 166–173.
    CrossRefPubMed
  31. DiSipio T, Rye S, Newman B, et al. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 2013; 14(6): 500–515.
    CrossRefPubMed
  32. Soran A, D'Angelo G, Begovic M, et al. Breast cancer-related lymphedema--what are the significant predictors and how they affect the severity of lymphedema? Breast J. 2006; 12(6): 536–543.
    CrossRefPubMed
  33. Kim M, Kim SW, Lee SUk, et al. A model to estimate the risk of breast cancer-related lymphedema: combinations of treatment-related factors of the number of dissected axillary nodes, adjuvant chemotherapy, and radiation therapy. Int J Radiat Oncol Biol Phys. 2013; 86(3): 498–503.
    CrossRefPubMed
  34. Ridner SH, Montgomery LD, Hepworth JT, et al. Comparison of upper limb volume measurement techniques and arm symptoms between healthy volunteers and individuals with known lymphedema. Lymphology. 2007; 40(1): 35–46.
    PubMed
  35. Taylor R, Jayasinghe UW, Koelmeyer L, et al. Reliability and validity of arm volume measurements for assessment of lymphedema. Phys Ther. 2006; 86(2): 205–214.
    PubMed
  36. Tewari N, Gill PG, Bochner MA, et al. Comparison of volume displacement versus circumferential arm measurements for lymphoedema: implications for the SNAC trial. ANZ J Surg. 2008; 78(10): 889–893.
    CrossRefPubMed
  37. Sharkey AR, King SW, Kuo RY, et al. Measuring limb volume: accuracy and reliability of tape measurement versus perometer measurement. Lymphat Res Biol. 2018; 16(2): 182–186.
    CrossRefPubMed
  38. Tierney S, Aslam M, Rennie K, et al. Infrared optoelectronic volumetry, the ideal way to measure limb volume. Eur J Vasc Endovasc Surg. 1996; 12(4): 412–417.
    CrossRefPubMed
  39. Barrio AV, Eaton A, Frazier TG. A prospective validation study of bioimpedance with volume displacement in early-stage breast cancer patients at risk for lymphedema. Ann Surg Oncol. 2015; 22 Suppl 3(0 3): S370–S375.
    CrossRefPubMed
  40. Brunelle CL, Roberts SA, Horick NK, et al. Integrating symptoms into the diagnostic criteria for breast cancer-related lymphedema: applying results from a prospective surveillance program. Phys Ther. 2020; 100(12): 2186–2197.
    CrossRefPubMed
  41. Shah C, Arthur DW, Wazer D, et al. The impact of early detection and intervention of breast cancer-related lymphedema: a systematic review. Cancer Med. 2016; 5(6): 1154–1162.
    CrossRefPubMed
  42. Park JH, Merriman J, Brody A, et al. Limb volume changes and activities of daily living: a prospective study. Lymphat Res Biol. 2021; 19(3): 261–268.
    CrossRefPubMed
  43. Cemal Y, Pusic A, Mehrara BJ. Preventative measures for lymphedema: separating fact from fiction. J Am Coll Surg. 2011; 213(4): 543–551.
    CrossRefPubMed
  44. Gillespie TC, Sayegh HE, Brunelle CL, et al. Breast cancer-related lymphedema: risk factors, precautionary measures, and treatments. Gland Surg. 2018; 7(4): 379–403.
    CrossRefPubMed
  45. Duygu Yildiz E, Bakar Y, Keser I. What do lymphedema patients expect from a treatment and what do they achieve? A descriptive study. J Vasc Nurs. 2022; 40(1): 59–65.
    CrossRefPubMed
  46. Alcorso J, Sherman KA, Koelmeyer L, et al. Psychosocial factors associated with adherence for self-management behaviors in women with breast cancer-related lymphedema. Support Care Cancer. 2016; 24(1): 139–146.
    CrossRefPubMed
  47. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372(71).
    CrossRef
  48. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339: b2700.
    CrossRefPubMed
  49. Introduction: What is MeSH? https://www.nlm.nih.gov/bsd/disted/meshtutorial/introduction/index.html (15.10.2022).
  50. Haddaway NR, Page MJ, Pritchard CC, et al. : An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Syst Rev. 2022; 18(2): e1230.
    CrossRefPubMed
  51. Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009) — Centre for Evidence-Based Medicine (CEBM), University of Oxford. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009 (26.10.2022).
  52. Hidding JT, Viehoff PB, Beurskens CHG, et al. Measurement properties of instruments for measuring of lymphedema: systematic review. Phys Ther. 2016; 96(12): 1965–1981.
    CrossRefPubMed
  53. Risk Reduction Practices. National Lymphoedema Network. https://lymphnet.org/risk-reduction-practices (24.10.2022).
  54. be.macmillan — Understanding lymphoedema. https://be.macmillan.org.uk/be/p-24703-understanding-lymphoedema.aspx (26.10.2022).
  55. Ferguson CM, Swaroop MN, Horick N, et al. Impact of ipsilateral blood draws, injections, blood pressure measurements, and air travel on the risk of lymphedema for patients treated for breast cancer. J Clin Oncol. 2016; 34(7): 691–698.
    CrossRefPubMed
  56. Asdourian MS, Swaroop MN, Sayegh HE, et al. Association between precautionary behaviors and breast cancer-related lymphedema in patients undergoing bilateral surgery. J Clin Oncol. 2017; 35(35): 3934–3941.
    CrossRefPubMed
  57. Kilbreath SL, Refshauge KM, Beith JM, et al. Risk factors for lymphoedema in women with breast cancer: a large prospective cohort. Breast. 2016; 28: 29–36.
    CrossRefPubMed
  58. Hershko DD, Stahl S. Safety of elective hand surgery following axillary lymph node dissection for breast cancer. Breast J. 2007; 13(3): 287–290.
    CrossRefPubMed
  59. Fulford D, Dalal S, Winstanley J, et al. Hand surgery after axillary lymph node clearance for breast cancer: contra-indication to surgery? Ann R Coll Surg Engl. 2010; 92(7): 573–576.
    CrossRefPubMed
  60. Baltzer HL, Harvey J, Fox PM, et al. De novo upper extremity lymphedema after elective hand surgery in breast cancer survivors. Ann Plast Surg. 2017; 79(1): 24–27.
    CrossRefPubMed
  61. Naranjo J, Portner ER, Jakub JW, et al. Ipsilateral intravenous catheter placement in breast cancer surgery patients. Anesth Analg. 2021; 133(3): 707–712.
    CrossRefPubMed
  62. Olsha O, Goldin I, Man V, et al. Ipsilateral hemodialysis access after axillary dissection for breast cancer. Breast Cancer Res Treat. 2012; 132(3): 1173–1176.
    CrossRefPubMed
  63. Gunnoo N, Ebelin M, Arrault M, et al. Impact of carpal tunnel syndrome surgery on women with breast cancer-related lymphedema. Breast Cancer Res Treat. 2015; 152(3): 683–686.
    CrossRefPubMed
  64. Khanbabayi GM, Eidy M, Zamani Esfahlani E. Frequency ratio of carpal tunnel syndrome in women with breast cancer treated with lymphedema in tabriz medical education centers; 2018-2019. Iran J Obstet Gynecol Infertil. 2020; 22(12): 62–68.
    CrossRef
  65. Showalter SL, Brown JC, Cheville AL, et al. Lifestyle risk factors associated with arm swelling among women with breast cancer. Ann Surg Oncol. 2013; 20(3): 842–849.
    CrossRefPubMed
  66. Koelmeyer LA, Gaitatzis K, Dietrich MS, et al. Risk factors for breast cancer-related lymphedema in patients undergoing 3 years of prospective surveillance with intervention. Cancer. 2022; 128(18): 3408–3415.
    CrossRefPubMed
  67. Liu N. Etiology of primary lymphoedema. In: Peripheral lymphoedema. Springer 2021: 53–61.
  68. Norman SA, Miller LT, Erikson HB, et al. Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer. Phys Ther. 2001; 81(6): 1192–1205.
    PubMed
  69. Czerniec SA, Ward LC, Kilbreath SL. Breast cancer-related arm lymphedema: fluctuation over six months and the effect of the weather. Lymphat Res Biol. 2016; 14(3): 148–155.
    CrossRefPubMed
  70. Kelly PT, Seccombe LM, Rogers PG, et al. Directly measured cabin pressure conditions during Boeing 747–400 commercial aircraft flights. Respirology. 2007; 12(4): 511–515.
    CrossRefPubMed
  71. Paiva C, Dutra C. Prevalência de linfedema após tratamento de câncer de mama em pacientes com sobrepeso. Fisioterapia Pesquisa. 2016; 23(3): 263–267.
    CrossRef
  72. Nguyen TT, Hoskin TL, Habermann EB, et al. Breast cancer-related lymphedema risk is related to multidisciplinary treatment and not surgery alone: results from a large cohort study. Ann Surg Oncol. 2017; 24(10): 2972–2980.
    CrossRefPubMed
  73. Greene AK, Zurakowski D, Goss JA. Body mass index and lymphedema morbidity: comparison of obese versus normal-weight patients. Plast Reconstr Surg. 2020; 146(2): 402–407.
    CrossRefPubMed
  74. Leray H, Malloizel-Delaunay J, Lusque A, et al. Body mass index as a major risk factor for severe breast cancer-related lymphedema. Lymphat Res Biol. 2020; 18(6): 510–516.
    CrossRefPubMed
  75. Armer JM, Ballman KV, McCall L, et al. Factors associated with lymphedema in women with node-positive breast cancer treated with neoadjuvant chemotherapy and axillary dissection. JAMA Surg. 2019; 154(9): 800–809.
    CrossRefPubMed
  76. Hayes SC, Speck RM, Reimet E, et al. Does the effect of weight lifting on lymphedema following breast cancer differ by diagnostic method: results from a randomized controlled trial. Breast Cancer Res Treat. 2011; 130(1): 227–234.
    CrossRefPubMed
  77. Kilbreath SL, Refshauge KM, Beith JM, et al. Upper limb progressive resistance training and stretching exercises following surgery for early breast cancer: a randomized controlled trial. Breast Cancer Res Treat. 2012; 133(2): 667–676.
    CrossRefPubMed
  78. Kilbreath SL, Ward LC, Davis GM, et al. Reduction of breast lymphoedema secondary to breast cancer: a randomised controlled exercise trial. Breast Cancer Res Treat. 2020; 184(2): 459–467.
    CrossRefPubMed
  79. Anderson RT, Kimmick GG, McCoy TP, et al. A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial. J Cancer Surviv. 2012; 6(2): 172–181.
    CrossRefPubMed
  80. Ammitzbøll G, Kristina Kjær T, Johansen C, et al. Progressive resistance training to prevent arm lymphedema in the first year after breast cancer surgery: Results of a randomized controlled trial. Cancer. 2019; 125(10): 1683–1692.
    CrossRefPubMed
  81. Simonavice E, Kim JS, Panton L. Effects of resistance exercise in women with or at risk for breast cancer-related lymphedema. Support Care Cancer. 2017; 25(1): 9–15.
    CrossRefPubMed
  82. Cormie P, Galvão DA, Spry N, et al. Neither heavy nor light load resistance exercise acutely exacerbates lymphedema in breast cancer survivor. Integr Cancer Ther. 2013; 12(5): 423–432.
    CrossRefPubMed
  83. Bloomquist K, Karlsmark T, Christensen KB, et al. Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphoedema: a randomized trial. Acta Oncol. 2014; 53(2): 216–225.
  84. Li Ke, Zhang Z, Liu NF, et al. Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis. Lasers Med Sci. 2017; 32(3): 485–494.
    CrossRefPubMed
  85. Liu Nf, Wang Bs. Functional lymphatic collectors in breast cancer-related lymphedema arm. Lymphat Res Biol. 2014; 12(4): 232–237.
    CrossRefPubMed
  86. Mosti G, Cavezzi A. Compression therapy in lymphedema: between past and recent scientific data. Phlebology. 2019; 34(8): 515–522.
    CrossRefPubMed
  87. DeSnyder SM, Yi M, Boccardo F, et al. American society of breast surgeons' practice patterns for patients at risk and affected by breast cancer-related lymphedema. Ann Surg Oncol. 2021; 28(10): 5742–5751.
    CrossRefPubMed
  88. Guidelines. Lymphoedema Support Network — LSN. https://www.lymphoedema.org/healthcare-professionals/guidelines/ (16.10.2022).
  89. Lymphoedema treatment — lymphatic drainage massage, exercise. https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/lymphoedema (16.10.2022).
  90. Brush BE, Wylie JH, Benninson J, et al. The treatment of postmastectomy lymphedema. AMA Arch Surg. 1958; 77(4): 561–567.
    CrossRefPubMed
  91. LeVasseur N, Stober C, Ibrahim M, et al. Perceptions of vascular access for intravenous systemic therapy and risk factors for lymphedema in early-stage breast cancer-a patient survey. Curr Oncol. 2018; 25(4): e305–e310.
    CrossRefPubMed
  92. Halsted WS. The swelling of the arm after operations for cancer of the breast — elephantiasis chirurgica — its cause and prevention. Bull Johns Hopkins Hosp. 1921; 32: 309–313.
  93. Brennan MJ. Lymphedema following the surgical treatment of breast cancer: a review of pathophysiology and treatment. J Pain Symptom Manage. 1992; 7(2): 110–116.
    CrossRefPubMed
  94. Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM. 2005; 98(5): 343–348.
    CrossRefPubMed
  95. Simon M, Vignes S. Enquête en médecine générale sur les lymphœdèmes du membre supérieur après cancer du sein. JMV J Médecine Vasc. 2019; 44(1): 3–8.
    CrossRef
  96. Co M, Ng J, Kwong A. Air travel and postoperative lymphedema — a systematic review. Clin Breast Cancer. 2018; 18(1): e151–e155.
    CrossRefPubMed
  97. Kristensen N, Nymann C, Konradsen H. Implementing research results in clinical practice- the experiences of healthcare professionals. BMC Health Serv Res. 2016; 16: 48.
    CrossRefPubMed
  98. Treves N. An evaluation of the etiological factors of lymphedema following radical mastectomy; an analysis of 1,007 cases. Cancer. 1957; 10(3): 444–459, doi: 10.1002/1097-0142(195705/06)10:3<444::aid-cncr2820100306>3.0.co;2-7.
    PubMed
  99. Huang HP, Zeng Q, Zhou JR. Risk factors associated with lymphoedema among Chinese women after breast cancer surgery. Contemp Nurse. 2013; 44(1): 5–10.
    CrossRefPubMed
  100. Konishi T, Tanabe M, Michihata N, et al. Risk factors for arm lymphedema following breast cancer surgery: a Japanese nationwide database study of 84,022 patients. Breast Cancer. 2023; 30(1): 36–45.
    CrossRefPubMed
  101. Petrek J, Senie R, Peters M, et al. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001; 92(6): 1368–1377, doi: 10.1002/1097-0142(20010915)92:6<1368::aid-cncr1459>3.0.co;2-9.
  102. McKenzie DC. Abreast in a boat — a race against breast cancer. Cmaj. 1998; 159(4): 376–378.
  103. Devenish E, Jessop W. The nature and cause of swelling of the upper limb after radical mastectomy. Br J Surg. 1940; 28(110): 222–238.
  104. Karlsson K, Biguet G, Johansson K, et al. Perceptions of lymphoedema treatment in patients with breast cancer — a patient perspective. Scand J Caring Sci. 2015; 29(1): 110–117.
    CrossRefPubMed
  105. Cheng CT, Deitch JM, Haines IE, et al. Do medical procedures in the arm increase the risk of lymphoedema after axillary surgery? A review. ANZ J Surg. 2014; 84(7–8): 510–514.
    CrossRefPubMed
  106. Rebegea L, Firescu D, Dumitru M, et al. The incidence and risk factors for occurrence of arm lymphedema after treatment of breast cancer. Chirurgia (Bucur). 2015; 110(1): 33–37.
    PubMed
  107. Gaston R, Osier L, Lewis D, et al. Lymphedema following elective hand and wrist surgery in women who are post axillary lymph node dissection: a prospective, cohort study. J Hand Surg. 2016; 41(9): S2–S3.
    CrossRef
  108. Tsai RJ, Dennis LK, Lynch CF, et al. Lymphedema following breast cancer: the importance of surgical methods and obesity. Front Womens Health. 2018; 3(2).
    CrossRefPubMed

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