© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 2, 96-111,
January 17, 2001
© 2001 Oxford University Press
REVIEW |
Arm Edema in Breast Cancer Patients
Affiliations of authors: V. S. Erickson, RAND Health, Santa Monica, CA, and the University of California Los Angeles (UCLA) School of Nursing; M. L. Pearson, RAND Health; P. A. Ganz, UCLA Jonsson Comprehensive Cancer Center and the UCLA Schools of Medicine and Public Health; J. Adams, RAND Statistics Group, Santa Monica; K. L. Kahn, RAND Health and UCLA Department of Medicine, Division of General Internal Medicine and Health Services Research.
Correspondence to: Katherine L. Kahn, M.D., RAND, P.O. Box 2138, 1700 Main St., Santa Monica, CA 90407-2138 (e-mail: kahn{at}rand.org).
The improvement in the life expectancy of women with breast cancer raises important questions about how to improve the quality of life for women sustaining complications of breast cancer treatment. In particular, attention to common problems, such as arm edema, is of critical importance. We reviewed published breast cancer guidelines and literature identified via MEDLINE® searches in an effort to summarize the research literature pertinent to management of breast cancer-related arm edema, including incidence, prevalence, and timing; risk factors; morbidity; prevention; diagnosis; and efficacy of nonpharmacologic and pharmacologic interventions. We found that arm edema is a common complication of breast cancer therapy that can result in substantial functional impairment and psychological morbidity. The risk of arm edema increases when axillary dissection and axillary radiation therapy are used. Recommendations for preventive measures, such as avoidance of trauma, are available, but these measures have not been well studied. Nonpharmacologic treatments, such as massage and exercise, have been shown to be effective therapies for lymphedema, but the effect of pharmacologic interventions remains uncertain. Comparing results across studies is complicated by the fact that the definitions of interventions and measures of outcomes and risk stratification vary substantially among studies. As arm edema becomes more prevalent with the increasing survival of breast cancer patients, further research is needed to evaluate the efficacy of preventive strategies and therapeutic interventions.
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