Comprehensive overview of management and risk assessment of breast cancer-related lymphedema: a multidisciplinary approach

Breast cancer is one of the most commonly diagnosed cancers worldwide, with a particularly high incidence in women. Although many are cured of their malignancy, treatment options can present with significant long-term complications for the patient. Lymphedema is the accumulation of protein-rich fluid that occurs following a disturbance to the lymphatic system. Secondary lymphedema to the arm often results following breast surgery or axillary lymph node dissection, although risk and exacerbating factors include radiation and medical chemotherapy, both in the short- and long-term intervals. Breast cancer-related lymphedema (BCRL) develops secondary to treatment-related lymphatic injury, commonly involving the axillary lymphatic system, with clinical manifestations that may affect the ipsilateral arm, hand, breast, chest wall, and axilla. This article serves as an updated and comprehensive review of the available peer-reviewed literature regarding the pathophysiology, incidence, predictive/risk factors, clinical features, diagnostic strategies, comparative accuracy and utility of early detection and surveillance approaches, preventive strategies, and guidelines-based conservative/surgical/emerging management approaches for BCRL. The purpose of this review is to apprise healthcare professionals with the latest understanding of optimal care and counseling patients regarding BCRL.