Article
Lymphedema inbreast cancer patients - Consensus recommendations for the postoperative management of breast cancer patients
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Published: | March 20, 2006 |
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Outline
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Secondary lymph edema is one of the most frequent long-term side effects affecting up to 30% of all breast cancer patients after local surgical and radiation treatment. The distruction of the lymphatic system causes a progressive and chronic condition with functional impairments and disabilities limiting patients in their daily activities involving nearly all aspects of their quality of life. The need for improving oncological management for early diagnosis and referral for effective treatment of lymph edema is a major goal of breast cancer heath care while survival improves. Methode: A systematic consensus process was performed involving all relevant partners and providers of lymph edema health care to develop a practical documentation concept and make recommendations according to the evidence of clinical studies and current available guidelines. Results: A practical concept of documentation with defined assessment points including the assessment of quality of life parameters with recognised instruments by the patient themselves for evaluation and monitoring of lymph edema was developed. Consensus recommendations for the postoperative management, prevention, treatment and follow-up of breast cancer patients alongside a clinical algorithm for in- and outpatient care were finalized. Conclusion: With improved survival long-term side effects with major impact on quality of life become a most important end point criteria of oncological treatment. The clear defined documentation concept and the comprehensive recommendations for lymph edema management may assist clinicians and patients to make timely decisions about in- and outpatient health care practice. Patients compliance with treatment and prevention routines will be as important as ensuring the continuity of care. A longitudinal prospective study evaluating the effectiveness and efficacy of the consensus recommendation is currently implemented.