Date Presented 04/04/2025
The purpose of this study was to map evidence about patient precautions for breast cancer–related lymphedema onset and progression. Results indicate a need to review prevention precautions and conduct research targeting identified gaps.
Primary Author and Speaker: Julie H. Hunley
Contributing Authors: David Doubblestein, Elizabeth Campione
PURPOSE: The purpose of this study was to identify and appraise the current evidence base for behavioral risks for breast cancer-related lymphedema (BCRL) diagnosis or progression to inform revised BCRL precautions and identify gaps for future research. Occupational therapy practitioners need evidence-based recommendations to update the BCRL patient precautions in clinical settings.
DESIGN: An evidence mapping review design was selected because the design accommodates the systematic and critical review of a wide body of evidence of various designs and the presentation of findings in a highly accessible visual format.
METHOD: Literature searches were conducted in Medline, CINAHL, and Cochrane for the historic precaution categories of trauma, blood pressure, temperature, air travel, and behavior change yielding 2014 studies. Thirty-seven studies were included in the final review. Each study was screened and reviewed for predefined eligibility by two blind reviewers with a third blind reviewer serving as referee resulting in final decisions by consensus. The level of evidence was determined, studies were synthesized, and confidence levels were assigned. Results were illustrated in bubble maps and evidence tables.
RESULTS: Neither isolated blood pressure measurements nor blood draws and injections in the at-risk arm did not increase arm volume in those at risk for BCRL. Air travel was not a significant risk factor for the onset of BCRL. Elective surgery is generally not associated with an increased risk of BCRL. Hot climate temperature was not a significant risk for the onset of lymphedema but may be a risk for the progression of BCRL.
CONCLUSION: The findings of this review identified the need for updating BCRL diagnosis risks and gaps in evidence about BCRL progression risk. These findings will have a significant impact on occupational therapy practitioners providing patient education about reducing the risk of diagnosis or progression of BCRL.
References
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