Current evidence on patient precautions for reducing breast cancer-related lymphedema manifestation and progression risks.

Abstract

Risk management and self-management strategies for breast cancer-related lymphedema (BCRL) must balance best-evidence guidelines and associated risk factor knowledge. There is an evidence-based practice gap in the understanding of whether a change in education about risk factors and whether behavioral changes actually influence BCRL manifestation or progression. The purpose of this study was to (1) review if current evidence supports or refutes patient precautions to prevent the manifestation and/or progression of BCRL, (2) review if behavioral changes result in the prevention or reduction of BCRL, and (3) identify related gaps of knowledge for future research. Evidence map methodology was used to systematically review literature related to reducing the risk of BCRL. Literature searches were conducted in Medline, CINAHL, and Cochrane for the categories of trauma, blood pressure, temperature, air travel, and behavior change. One hundred and forty-eight articles were included for full-text review, of which 37 articles were included in this study. Within the confines of limb and trunk circumferential and/or volume enlargement, a 'just in case' approach to patient education on risk factors may not be appropriate for breast cancer survivors at risk of manifesting lymphedema. Patient education about precautionary risks for the onset of BCRL needs to align with research evidence. There is scant evidence about the risks of BCRL progression suggesting a need for future research.