Shah, C., Arthur, D.W., Wazer, D., Khan, A., Ridner, S., & Vicini, F. (2016). The impact of early detection and intervention of breast cancer-related lymphedema: A systematic review. Cancer Medicine, 5, 1154–1162. 

DOI Link

Purpose

STUDY PURPOSE: To examine the literature about early detection and the management of breast cancer-related lymphedema (BCRL)

TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: MEDLINE
 
INCLUSION CRITERIA: Published studies in English between 1990–2015 evaluating patients treated for breast cancer with early lymphedema intervention and/or diagnostic assessment
 
EXCLUSION CRITERIA: Studies with a lack of clear lymphedema assessment/intervention or outcomes, or studies with outcomes not within the scope of the review

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 127 
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: A single physician independently evaluated the articles. Data from the articles, including study type, institution, number of patients, follow-up, interventions utilized/techniques, assessment methods and procedure, and documented outcomes were extracted. Study bias, including assessment techniques, conflicts of interest, and statistical analysis methods, was examined.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 13
  • TOTAL PATIENTS INCLUDED IN REVIEW = Not clearly described (only nine studies were listed in Table 1; the information from the other four studies is missing)
  • SAMPLE RANGE ACROSS STUDIES: 37–1,713 (based on Table 1)
  • KEY SAMPLE CHARACTERISTICS: Patients with breast cancer at risk for or with lymphedema

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

Early intervention (physiotherapy, manual lymphatic drainage [MLD]) demonstrates a benefit of reducing the rate of BCRL. New diagnostic modalities (e.g., perometry, bioimpedance spectroscopy) may increase sensitivity for early detection of BCRL.

Conclusions

Developing surveillance programs that target early identification and timely interventions for BCRL management is important.

Limitations

  • Limited search
  • No quality evaluation
  • Low sample sizes
  • Thirteen articles were identified by the authors as meeting the eligibility criteria and the scope of the review; however, only nine articles/studies were clearly evaluated and presented in the results section as well as in Table 1.

Nursing Implications

The review supports the beneficial impact of early detection and timely interventions of BCRL. This will inform nurses of using evidence-based strategies to make early identification and management of lymphedema in individuals with breast cancer. The quality of the review, however, is not adequate.

Legacy ID

6136