Women need to be well-informed about options for minimising harm from breast cancer treatment / Acting early could avoid long-term problems like lymphedema

Opting for less damaging treatments, staying active and learning about the warning signs of lymphedema: that’s how women with breast cancer can avoid developing chronic lymphedema, according to the German Institute for Quality and Efficiency in Health Care (IQWiG).

Protecting women’s lymph systems
Breast cancer treatment is becoming more effective, with a survival rate of more than 80% for this disease in Germany. As the survival rate goes up, quality of life for survivors assumes even more importance, according to the German Institute. Lymphedema is an adverse effect of breast cancer treatment caused by damage to the lymph system. When the lymph system cannot properly remove fluids from around the breast and arm, the fluid gathers and the arm swells. This causes pain and restricts movement. It could become a chronic problem that is hard to treat.

The more aggressive breast cancer treatment is, the higher the risk of lymphedema. Researchers estimate around 400,000 women in Germany alone have lymphoedema caused by breast cancer treatment.

“Even with many women having less aggressive breast cancer treatments, around 10 to 20% will develop lymphedema,” according to Professor Peter Sawicki, the Institute’s Director. “We doctors still underestimate the impact on patients’ quality of life of treatment adverse effects like lymphedema. The first step to prevention is using therapies that limit the damage to the woman’s lymph system.”

Better quality of life after breast cancer

The second step to better quality of life is to stay active. For years, there were many warnings to women to limit the use of the arm and be careful about being too active after breast cancer treatment. But Professor Sawicki said, “While women who are developing lymphedema have to protect their arms more, the blanket warnings from the past to all women with breast cancer were never based on strong scientific evidence. In fact, trials of exercise in women with breast cancer have shown that it can improve quality of life without increasing the risk of lymphedema.”

However women need to learn about the warning signs of lymphedema and act early. “A feeling of heaviness, heat and swelling in the arm - women need to take action early when this happens in the years after breast cancer treatment,” Professor Sawicki said. “Lymphedema is easier to treat effectively in the early stages.”

The treatment shown to be effective in trials is compression therapy with bandages or compression sleeves. A special massage technique called lymphatic drainage as well as physiotherapy might be able to help, but this has not been so well-studied. Women can learn more about the condition and what could help at http://www.informedhealthonline.org.

The Institute’s website, http://www.informedhealthonline.org, provides the public with easy-to-understand information about current medical developments and research on important health issues. If you would like to be kept up-to-date with the latest publications on the independent health information website, you can subscribe to the informedhealthonline.org newsletter.

Source for data on lymphedema in Germany:

Seifart U, Albert U-S, Helm M-E, Hübner J et al. [Lymphedema in patients with breast cancer-a consensus regarding diagnostics and therapy in patients with postoperative lymphedema after primary breast cancer.] Rehabilitation (Stuttg) 2007; 46: 340-348. [PubMed summary]

 

Contact:

Hilda Bastian
Editor-in-Chief, Informed Health Online

German Institute for Quality and Efficiency in Health Care (IQWiG)

Tel.: +49 (0)221 / 356 85-0, E-Mail: .(JavaScript must be enabled to view this email address)