Test, Trigger, Treat
Breast cancer-related lymphedema (BCRL) represents a major source of morbidity among breast cancer survivors.
Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. Breast cancer is the second most common cancer among women in the United States (some kinds of skin cancer are the most common).
Each year in the United States, about 264,000 cases of breast cancer are diagnosed in women and about 2,400 in men. About 42,000 women and 500 men in the U.S. die each year from breast cancer.
Causes of breast cancer-related lymphedema (BCRL)
If breast cancer spreads, it tends to move into the underarm lymph nodes because these nodes drain lymph from the breast. That’s why breast cancer surgeons often remove at least two or three lymph nodes from under the arm — called a sentinel lymph node biopsy (SLNB).
When surgeons have to remove many or most of the underarm nodes, it’s called an axillary lymph node dissection (ALND). These surgeries can cut off or damage some of the nodes and vessels that make up the pathways that lymph moves through. Over time, lymph can build up and overwhelm the remaining pathways, resulting in lymphedema — sometimes months or even years after breast cancer treatment ends. Radiation treatments also can affect the lymphatic system. The risk of radiation-related lymphedema is highest in people who receive radiation directly to the underarm because it’s where most of the lymph nodes are located. 1
Lymphedema is abnormal swelling that happens when too much lymph collects in any part of the body. Lymph is a thin, clear fluid that circulates through the lymphatic system to remove waste, bacteria and other substances from the body’s tissues. Edema is the buildup of excess fluid.
Twenty- five percent of individuals with axillary lymph node dissection have a lifetime risk of developing lymphedema.
Is BCRL preventable?
A recent study, the PREVENT study2 published in May of 2019 in the Annals of Surgical Oncology demonstrates clear clinical evidence that the early use of the Bioimpedance screening surveillance and utilization of compression garments is an effective tool in lymphedema prevention.
Bioimpedance Spectroscopy (BIS) is a technique used for estimating body composition that utilizes a weak electric current which flows through the body and the voltage is measured in order to calculate impedance (resistance) of the body.
As for the compression garment used, the innovative mediven® harmony arm sleeve was used in the study. Specifically, a mediven harmony 20-30 mmHg arm sleeve and a 20-30 mmHg gauntlet or glove was prescribed for those in the study who TRIGGERED positive. Patients who immediately entered compression therapy treatment and were compliant with the protocol, significantly reduced their chances of late-stage lymphedema.
Use of the mediven harmony arm sleeves and gauntlets assisted in preventing the progression of subclinical lymphedema in the largest randomized controlled trial focused on lymphedema prevention.
Therefore, it’s clear that early detection and compression prevents! All patients who have had breast cancer intervention are at risk for lymphedema.
References:
1. Breastcancer.org.
2. Original Publication: A Randomized Trial Evaluating Bioimpedance Spectroscopy Versus Tape Measurement for the Prevention Of Lymphedema Following Treatment for Breast Cancer: Interim Analysis Journal: Annals of Surgical Oncology Publication Date: May 2019 Authors: Ridner et al
