title: Surveillance recommendations in reducing risk of and optimally managing breast cancer-related lymphedema.
abstract: Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance.
authors.affiliation: Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA. plo7c9@mail.missouri.edu.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Ostby
authors.affiliation: Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA. armer@missouri.edu.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Armer
authors.affiliation: Ellis Fischel Cancer Center, One Hospital Drive, Columbia, MO 65212, USA. daleps@health.missouri.edu.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Dale
authors.affiliation: Ellis Fischel Cancer Center, One Hospital Drive, Columbia, MO 65212, USA. vanloomj@health.missouri.edu.
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Van Loo
authors.affiliation: Ellis Fischel Cancer Center, One Hospital Drive, Columbia, MO 65212, USA. wilbanksc@health.missouri.edu.
authors.forename: Cassie L
authors.initials: CL
authors.lastname: Wilbanks
authors.affiliation: Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA. stewartb@missouri.edu.
authors.forename: Bob R
authors.initials: BR
authors.lastname: Stewart