Breast Cancer-Related Lymphedema Research Program, Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, MA, USA.
McGill Lymphedema Research Program, Montreal, QC, Canada.
Med Oncol. 2024 Oct 23;41(11):298. doi: 10.1007/s12032-024-02510-6.
Several recent studies have investigated the validity of precautionary practices for lymphedema risk reduction after breast cancer treatment, such as avoidance of blood pressure measurements, skin puncture, blood draws, and use of prophylactic compression during air travel. Other studies have elucidated risk factors for breast cancer-related lymphedema, such as axillary lymph node dissection and skin infection (cellulitis). Combining the current evidence base with the consensus opinion of lymphatic experts assembled at the American Cancer Society/Lymphology Association of North America Summit in October 2023, updated evidence-based risk reduction recommendations are presented for those with or at risk of breast cancer-related lymphedema. Recommendation topics include prospective surveillance, patient education, individual risk factors, exercise, blood pressure, skin care and hygiene, skin puncture and blood draws, surgical procedures, prophylactic compression, air travel, and hot climate and sauna. These recommendations will help inform education and medical choices for individuals treated for breast cancer who are at risk of or diagnosed with breast cancer-related lymphedema. More high-quality evidence is required to allow the development of risk reduction recommendations for other cancer types such as gynecological, melanoma, and head and neck. It is recommended that clinicians and organizations serving people at risk of or with lymphedema align risk reduction guidelines with the evidence-based recommendations provided within this consensus document and companion manuscripts from the American Cancer Society/Lymphology Association of North America Lymphedema Summit: Forward Momentum: Future Steps in Lymphedema Management.
近年来，多项研究调查了乳腺癌治疗后预防淋巴水肿风险的预防措施的有效性，如避免血压测量、皮肤穿刺、采血以及在航空旅行中使用预防性压缩。其他研究阐明了乳腺癌相关淋巴水肿的危险因素，如腋窝淋巴结清扫术和皮肤感染（蜂窝织炎）。将当前的证据基础与 2023 年 10 月在美国癌症协会/北美淋巴协会峰会上聚集的淋巴专家的共识意见相结合，为那些有或有乳腺癌相关淋巴水肿风险的人提出了更新的基于证据的风险降低建议。建议主题包括前瞻性监测、患者教育、个体危险因素、运动、血压、皮肤护理和卫生、皮肤穿刺和采血、手术程序、预防性压缩、航空旅行以及炎热气候和桑拿。这些建议将有助于为接受乳腺癌治疗且有或被诊断为乳腺癌相关淋巴水肿风险的个人提供教育和医疗选择。需要更多高质量的证据来制定其他癌症类型（如妇科、黑色素瘤和头颈部）的风险降低建议。建议为有淋巴水肿风险或患有淋巴水肿的临床医生和组织与本共识文件中提供的基于证据的建议以及美国癌症协会/北美淋巴协会淋巴水肿峰会的配套文件相匹配：向前迈进：淋巴水肿管理的未来步骤。
