Preventing upper-limb lymphoedema after breast cancer

About one in five people treated for breast cancer develop lymphoedema later on. This can be a debilitating long term sequela of breast cancer treatment. This article reviews the current available evidence (10 studies) to determine whether any intervention could help prevent clinical lymphoedema.

Outcome measures included amount of lymphoedema, infection, range of motion of the shoulder, pain, psychosocial morbidity, level of functioning in activities of daily life (ADL), and health-related quality of life (HRQoL). The heterogeneity of included studies made it difficult to draw conclusion on the results.

Based on the current available evidence, the authors cannot draw firm conclusions about the effectiveness of interventions containing MLD.

The evidence does not indicate a higher risk of lymphoedema when starting shoulder-mobilising exercises early after surgery compared to a delayed start (i.e. seven days after surgery).

Shoulder mobility (that is, lateral arm movements and forward flexion) is better in the short term when starting shoulder exercises earlier compared to later.

The evidence suggests that progressive resistance exercise therapy does not increase the risk of developing lymphoedema, provided that symptoms are closely monitored and adequately treated if they occur.