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Prevention of lymphoedema after axillary surgery for breast cancer

BMJ 2010; 340 doi: (Published 13 January 2010) Cite this as: BMJ 2010;340:b5235
  1. Andrea Cheville, associate professor of physical medicine and rehabilitation
  1. 1Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
  1. cheville.andrea{at}

    Physiotherapy shows promise in a selected group of women

    Lymphoedema is a potential complication of the treatment of primary breast cancer that reduces the quality of life of millions of breast cancer survivors.1 Cure is not possible and patients have a life long dependence on compression garments and other labour intensive treatments to prevent worsening of the condition’s hallmarks—arm swelling and discomfort.

    The recognition that more extensive surgery and radiation substantially increase a woman’s risk of developing lymphoedema has spurred on the development of treatments that lessen lymphatic injury, such as sentinel lymph biopsy.2 Nevertheless, about a third of patients with breast cancer present with lymph node positive disease and cannot benefit from these treatments because they need surgical clearance and perhaps irradiation of their axillary lymph nodes.3 As many as 60% of patients who undergo axillary lymph node resection and irradiation will eventually develop lymphoedema.4 Therefore, an intervention that could reduce the risk of lymphoedema after treatment would be an important advance. None is presently known.

    In the linked study (doi:10.1136/bmj.b5396),5 Lacomba and colleagues report a randomised controlled trial that assessed the effectiveness of the …

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