TY - JOUR
T1 - Early Referral for Breast-Cancer-Related Lymphedema: Do We Follow the Evidence?
T2 - A Two-Year Prospective Multicenter Cohort Study
AU - Hendrickx, Ad
AU - van der Schans, Cees P.
AU - Krijnen, Wim
AU - Mouës-Vink, Chantal M.
AU - Damstra, Robert
AU - Küthe, Saskia W.
PY - 2022/12/6
Y1 - 2022/12/6
N2 - The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change ≥5%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.
AB - The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change ≥5%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.
KW - borstkanker
KW - secundair lymfoedeem
KW - vroegtijdige opsporing
KW - 2 jaar follow-up
KW - doorverwijzing
KW - cohort studie
KW - waakzaam wachten
KW - therapie
KW - breast cancer
KW - secondary lymphedema
KW - early detection
KW - 2-years follow-up
KW - referral
KW - cohort study
KW - watchful waiting
KW - therapy
U2 - https://doi.org/10.3390/cancers14236016
DO - https://doi.org/10.3390/cancers14236016
M3 - Article
C2 - 36497495
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 23
ER -