Paolo Marchica1, Salvatore D'Arpa2, Stefano Magno3, Cristina Rossi3, Luana Forcina3, Vita Capizzi2, Sebastiano Oieni2, Carmela Amato4, Dario Piazza5, Vittorio Gebbia6,7. 1. Plastic Surgery Unit, University of Padua, Padua, Italy. 2. Plastic Surgery and Breast Unit, La Maddalena Clinic for Cancer, Palermo, Italy. 3. Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 4. Serena a Palermo Association, Palermo, Italy. 5. GSTU Foundation for Cancer Research, Palermo, Italy. 6. GSTU Foundation for Cancer Research, Palermo, Italy; vittorio.gebbia@gmail.com. 7. Integrative Medicine in Oncology Program, Medical Oncology Unit, La Maddalena Clinic for Cancer, Palermo, Italy.
Abstract
BACKGROUND/AIM: Upper limb breast cancer-related lymphedema (BCRL) is a chronic and severe condition affecting a significant percentage of breast cancer survivors. Even though its physiopathology is well-known, there is no worldwide consensus on BCRL evaluation and a gold-standard treatment. This narrative review aims at providing a brief descriptive overview with regard to BCRL treatment modalities. MATERIALS AND METHODS: We conducted a literature search within the PubMed database, and 33 articles out of 56 were selected, including reviews, systematic reviews, and meta-analyses aiming find the most updated evidence regarding BCRL treatment modalities. RESULTS: Physical exercise (aerobic exercise, resistance exercise, aquatic therapy), bandages, and intermittent pneumatic compression were shown to be most effective in BCRL patients, in terms of swelling reduction in the acute-intensive phase. Furthermore, physical exercise was beneficial also as a maintenance tool. Manual lymphatic drainage demonstrated efficacy in preventing secondary lymphedema if applied immediately after breast cancer surgery or in early phases of BCRL or as a maintenance tool. Complementary procedures such as acupuncture, reflexology, yoga and photo-biomodulation therapy did not show conclusive results in BCRL treatment. Surgery was shown effective in managing symptoms (liposuction), preventing (lymphaticovenular anastomosis) and treating BCRL (vascularized lymph node transfer). CONCLUSION: BCRL is still a challenging condition either for breast cancer survivors and clinicians, deeply impacting patient functioning and quality of life. Due to the lack of globally accepted criteria in evaluating BCRL, to date a gold standard treatment for this widespread issue is still needed.
BACKGROUND/AIM: Upper limb breast cancer-related lymphedema (BCRL) is a chronic and severe condition affecting a significant percentage of breast cancer survivors. Even though its physiopathology is well-known, there is no worldwide consensus on BCRL evaluation and a gold-standard treatment. This narrative review aims at providing a brief descriptive overview with regard to BCRL treatment modalities. MATERIALS AND METHODS: We conducted a literature search within the PubMed database, and 33 articles out of 56 were selected, including reviews, systematic reviews, and meta-analyses aiming find the most updated evidence regarding BCRL treatment modalities. RESULTS: Physical exercise (aerobic exercise, resistance exercise, aquatic therapy), bandages, and intermittent pneumatic compression were shown to be most effective in BCRL patients, in terms of swelling reduction in the acute-intensive phase. Furthermore, physical exercise was beneficial also as a maintenance tool. Manual lymphatic drainage demonstrated efficacy in preventing secondary lymphedema if applied immediately after breast cancer surgery or in early phases of BCRL or as a maintenance tool. Complementary procedures such as acupuncture, reflexology, yoga and photo-biomodulation therapy did not show conclusive results in BCRL treatment. Surgery was shown effective in managing symptoms (liposuction), preventing (lymphaticovenular anastomosis) and treating BCRL (vascularized lymph node transfer). CONCLUSION: BCRL is still a challenging condition either for breast cancer survivors and clinicians, deeply impacting patient functioning and quality of life. Due to the lack of globally accepted criteria in evaluating BCRL, to date a gold standard treatment for this widespread issue is still needed.
Authors: María Nieves Muñoz-Alcaraz; Antonio José Jiménez-Vílchez; Mirian Santamaría-Peláez; Luis A Pérula-de Torres; María Victoria Olmo-Carmona; María Teresa Muñoz-García; Presentación Jorge-Gutiérrez; Jesús Serrano-Merino; Esperanza Romero-Rodríguez; Lorena Rodríguez-Elena; Raquel Refusta-Ainaga; María Pilar Lahoz-Sánchez; Belén Miró-Palacios; Mayra Medrano-Cid; Rosa Magallón-Botaya; Luis A Mínguez-Mínguez; Josefa González-Santos; Jerónimo J González-Bernal Journal: J Clin Med Date: 2022-04-16 Impact factor: 4.964
Authors: María Nieves Muñoz-Alcaraz; Luis A Pérula-de Torres; Antonio José Jiménez-Vílchez; Paula Rodríguez-Fernández; María Victoria Olmo-Carmona; María Teresa Muñoz-García; Presentación Jorge-Gutiérrez; Jesús Serrano-Merino; Esperanza Romero-Rodríguez; Lorena Rodríguez-Elena; Raquel Refusta-Ainaga; María Pilar Lahoz-Sánchez; Belén Miró-Palacios; Mayra Medrano-Cid; Rosa Magallón-Botaya; Mirian Santamaría-Peláez; Luis A Mínguez-Mínguez; Jerónimo J González-Bernal Journal: J Clin Med Date: 2022-03-28 Impact factor: 4.241