Treatment of breast cancer has improved dramatically over the last 2 decades. Although these treatment options have significantly increased the 5-year survival rates, they are not without lasting adverse effects. As survival continues to improve for older women, the development of most feared long-term complication, breast cancer–related lymphedema (BCRL), will increase and can be more severe with increased age-related comorbidities. Since currently no definitive cure for BCRL exists, prevention by limiting and/or eliminating risk factors is of prime importance. Preventive exercise and education are recommended to reduce the incidence of BCRL and to enhance quality of life. There are new studies that mention mapping the axillary lymphatics before/during surgery to reduce the incidence of BCRL, as a mean to avoid extensive lymph node dissection; however its not definitely clarified. New surgical approaches such as microsurgical lymphaticovenous anastomosis are promising. In this article, we review the literature and discuss BCRL incidence, diagnosis, and treatment considering elderly patients.
Department of Surgical Oncology, Breast Disease Unit, Lymphedema Clinic (Dr Balci), Lymphedema Education, Screening, Early Detection and Prevention Program, Magee-Womens Associates (Ms DeGore), and Breast Cancer Wellness Clinic (Dr Soran), Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania.
Correspondence: Atilla Soran, MD, MPH, FACS, Breast Disease Clinical Research Program, International Breast Fellowship Program, Lymphedema Program, and Breast Cancer Wellness Clinic, Ste 2601, 300 Halket St, Pittsburgh, PA, 15213 (firstname.lastname@example.org).
This study was supported by a grant from ImpediMed Inc, Tactile Systems Technology Inc.
The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.