Breast Cancer, Lymphedema and the Precautions – 2019 NLN Conference

The National Lymphedema Network is offering open access to all presentations from the October 2019 NLN Conference. The NLN states:

“May the presentations feed your hungry minds and inspire you to continue your efforts in the world of lymphology.”

There are many excellent presentations.  Below are those related to breast cancer, lymphoedema, and precautionary measures.

Precautionary Measures – Presenting the Evidence – Alphonse Taghian

October 26, 2019
Duration 43 minutes

This presentation provides a detailed overview of the research about the precautionary measures that are provided to women at risk or who have lymphedema following breast cancer. Before you watch the presentation Alphonse Taghian encourages you to explore your approach to precautionary measures. These are listed below. Make a note of which best describes you and then see if it changes by the end of the presentation.

Which of the following statements best describes your approach to precautionary behaviors?

  1. Patients should strictly adhere to the precautionary measures on their at-risk arm.
  2. Patients should follow precautionary measures on their at-risk arm only if they are high risk (i.e. Axillary Lymph Node Dissection and/or Regional Lymph Node Radiation)
  3. Patients should use the opposite arm if possible. Using the at-risk arm is not contraindicated.
  4. Patients do not need to follow any precautionary measures if they are regularly screened for lymphedema.
  5. Patients do not need to follow any precautionary measures.
  6. Providers should discuss the risks/benefits/evidence regarding precautionary measures and let the patient make the decision.

Some of the articles discussed in this presentation are open access.

Trends in risk reduction practices for the prevention of lymphedema in the first 12 months after breast cancer surgery.

McLaughlin SA1, Bagaria S, Gibson T, Arnold M, Diehl N, Crook J, Parker A, Nguyen J. J Am Coll Surg. 2013 Mar;216(3):380-9; quiz 511-3.

Do medical procedures in the arm increase the risk of lymphoedema after axillary surgery? A review.

Chris-Tin Cheng,* Jessica M. Deitch,* Ian E. Haines,† David J. Porter‡ and Sharon L. Kilbreath§. ANZ J Surg 84 (2014) 510–514

Breast cancer-related lymphoedema and venepuncture: a review and evidence-based recommendations

Adam D. Jakes1, Chris Twelves1,2. Breast Cancer Res Treat (2015) 154:455–461.

Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis

Maria S Asdourian, Melissa N Skolny, Cheryl Brunelle, Cara E Seward, Laura Salama, Alphonse G Taghian.   Vol 17   September 2016.

Clinical Question: In women who have undergone breast cancer surgery, including lymph node removal, do blood pressure measurements taken in the ipsilateral arm increase the risk of lymphedema?

Justin R. Bryant, DO, MBA (PGY-6)*, Raymond T. Hajjar, DO*, Christopher Lumley, DO*, Kongkrit Chaiyasate, MD**. OSMA Journal, October 2016: 477.

Considerations for Clinicians in the Diagnosis, Prevention, and Treatment of Breast Cancer-Related Lymphedema, Recommendations from an Expert Panel: Part 2: Preventive and Therapeutic Options.

Sarah A. McLaughlin, MD1, Sarah M. DeSnyder, MD2, Suzanne Klimberg, et al. Ann Surg Oncol (2017) 24:2827–2835.

Air Travel and Postoperative Lymphedema—A Systematic Review

Michael Co, Judy Ng, Ava Kwong. Clinical Breast Cancer February 2018.

Due Process for Guideline Writing – Sarah McLaughlin

October 26, 2019
Duration 10.41 minutes

This presentation explores the process of how to establish guidelines. These are illustrated by the development of the paper;

Considerations for clinicians in the diagnosis, prevention, and treatment of breast cancer-related lymphedema: Recommendations from a multidisciplinary expert ASBrS panel.

McLaughlin SA1, Staley AC2, Vicini F3, Thiruchelvam P4, Hutchison NA5, Mendez J6, MacNeill F7, Rockson SG8, DeSnyder SM9, Klimberg S10, Alatriste M11, Boccardo F12, Smith ML13, Feldman SM14. Ann Surg Oncol. 2017 Oct;24(10):2818-2826.

The Impact of Following the Lymphoedema Risk Reduction Recommendations – Melanie Thomas

October 26, 2019
Duration: 10.41 minutes

Take home message –  The fear of lymphoedema, for those that are at risk of lymphoedema following breast cancer, has been caused by health professionals. It may not be current health professionals but the fear has continued from many years earlier when rigid guidelines were created.

Panel of Experts

October 26, 2019
Duration: 32 minutes

This presentation has a variety of health professionals who explore their views on precautionary measures.