title: Lymphedema following treatment for breast cancer: a new approach to an old problem.
abstract: Lymphedema following treatment for breast cancer can be an irreversible condition with a profound negative impact on quality of life. The lack of consensus regarding standard definitions of clinically significant lymphedema and optimal methods of measurement and quantification are unresolved problems. Inconsistencies persist regarding the appropriate timing of intervention and what forms of treatment should be the standard of care. There are reports that early detection and intervention can prevent progression, however,the Level 1 evidence to support this hypothesis has yet to be generated. To assess these controversies, we propose the implementation of a screening program to detect early lymphedema in conjunction with a randomized, prospective trial designed to generate Level 1 evidence regarding the efficacy of early intervention and appropriate treatment strategies. Collaboration among institutions that manage breast cancer patients is essential to establish a standardized approach to lymphedema and to establish guidelines for best practice.
authors.affiliation: Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, MA 02114, United States.
authors.forename: Jean
authors.initials: J
authors.lastname: O'Toole
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Jammallo
authors.forename: Melissa N
authors.initials: MN
authors.lastname: Skolny
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Miller
authors.forename: Krista
authors.initials: K
authors.lastname: Elliott
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Specht
authors.forename: Alphonse G
authors.initials: AG
authors.lastname: Taghian
mesh_terms: D001943:Breast Neoplasms / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D011788:Quality of Life; D013997:Time Factors
keywords: Breast cancer; Lymphedema; Perometer; Screening