Arm edema in breast cancer patients

The improvement in the life expectancy of women with breast cancer raises i mportant questions about how to improve the quality of life for women susta ining 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(R ) searches in an effort to summarize the research literature pertinent to m anagement of breast cancer-related arm edema, including incidence, prevalen ce, and timing; risk factors; morbidity; prevention; diagnosis; and efficac y of nonpharmacologic and pharmacologic interventions. We found that arm ed ema is a common complication of breast cancer therapy that can result in su bstantial functional impairment and psychological morbidity, The risk of ar m edema increases when axillary dissection and axillary radiation therapy a re used. Recommendations for preventive measures, such as avoidance of trau ma, are available, but these measures have not been well studied. Nonpharma cologic treatments, such as massage and exercise, have been shown to be eff ective therapies for lymphedema, but the effect of pharmacologic interventi ons remains uncertain. Comparing results across studies is complicated by t he 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, furt her research is needed to evaluate the efficacy of preventive strategies an d therapeutic interventions.