You have free access to this content

Cancer

Cover image for Cancer

Supplement: American Cancer Society Lymphedema Workshop

15 December 1998

Volume 83, Issue S12B

Pages 2775–2890

  1. Original Articles

    1. Top of page
    2. Original Articles
    1. You have free access to this content
      Introduction (page 2775)

      Robert A. Smith

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2775::AID-CNCR24>3.0.CO;2-0

      Lymphedema can be a side effect of breast cancer treatment that results in chronic and debilitating arm swelling. In order to identify key issues in research, prevention, treatment, education, and advocacy, the American Cancer Society organized an international conference as a prelude towards new initiatives focused on reducing the risk of lymphedema, and meeting the needs of women who have developed this disease.

    2. You have free access to this content
      Incidence of breast carcinoma-related lymphedema (pages 2776–2781)

      Jeanne A. Petrek and Melissa C. Heelan

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2776::AID-CNCR25>3.0.CO;2-V

      • original image

      The reported incidence of lymphedema varies from 6% to 30% among modern studies. However, to date, a definitive study to determine lymphedema incidence has not been performed.

    3. You have free access to this content
      Surgical treatment and lymphedema (pages 2782–2787)

      Peter I. Pressman

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2782::AID-CNCR26>3.0.CO;2-2

      • original image
      • original image

      Axillary lymphadenectomy is an integral part of the surgical treatment of breast carcinoma and a major cause of lymphedema. Because lymph node status is the most important predictor of outcome, accuracy is important. As smaller tumors are detected by mammography and axillary metastases are encountered less frequently, other means of assessing the axilla, such as sentinel node biopsy, may prove to be equally informative and cause less morbidity. In certain tumors of favorable histologic type and size, the axillary lymphadenectomy may be omitted.

    4. You have free access to this content
      Breast radiotherapy and lymphedema (pages 2788–2797)

      Allen G. Meek

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2788::AID-CNCR27>3.0.CO;2-I

      • original image
      • original image
      • original image
      • original image

      The occurrence of arm lymphedema in the breast carcinoma patient is diminishing due to more conservative management of both the breast and the axilla. Identifiable patient management and technical factors affecting the risk of lymphedema can be optimized.

    5. You have free access to this content
      The pathophysiology of lymphedema (pages 2798–2802)

      Peter S. Mortimer

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2798::AID-CNCR28>3.0.CO;2-E

      • original image

      A review is presented of lymphatic physiology and the causes of lymphedema with particular reference to breast carcinoma-related lymphedema.

    6. You have free access to this content
      A review of measures of lymphedema (pages 2803–2804)

      Lynn H. Gerber

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2803::AID-CNCR29>3.0.CO;2-W

      A review of frequently used measures of lymphedema is presented. Determination of the presence and severity of lymphedema should be done routinely using reliable, cost effective, low risk, easily accessible techniques. A patient-administered questionnaire could be developed to provide reliable and valuable information about severity and impact of lymphedema on patient functioning.

    7. You have free access to this content
      Imaging techniques in the management and prevention of posttherapeutic upper limb edemas (pages 2805–2813)

      Pierre Bourgeois, Oliver Leduc and Albert Leduc

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2805::AID-CNCR30>3.0.CO;2-F

      Imaging techniques are reviewed that can be used to manage the posttherapeutic upper limb edema observed in breast carcinomas, to prevent the appearance of such complications, and to diagnose the possible lymphonodal evolution of the cancerous disease that may underlie these events.

    8. You have free access to this content
      Precipitating factors in lymphedema: Myths and realities (pages 2814–2816)

      Stanley G. Rockson

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2814::AID-CNCR31>3.0.CO;2-E

      Despite the high prevalence of mastectomy-related secondary lymphedema, the factors that predispose to its development remain poorly understood. Relevant published studies are reviewed here, suggesting that additional research in this area will likely foster enhanced patient education and produce more efficacious measures for the control of this common form of secondary lymphedema.

    9. You have free access to this content
      Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma (pages 2817–2820)

      Steven D. Passik and Margaret V. McDonald

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2817::AID-CNCR32>3.0.CO;2-2

      The psychological and functional impact of upper extremity lymphedema following breast carcinoma treatment and strategies for intervention and research to help women prevent the condition or enhance coping with it once it develops are discussed.

    10. You have free access to this content
      Overview of treatment options and review of the current role and use of compression garments, intermittent pumps, and exercise in the management of lymphedema (pages 2821–2827)

      Michael J. Brennan and Linda T. Miller

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2821::AID-CNCR33>3.0.CO;2-G

      Lymphedema is a common yet poorly understood complication of breast carcinoma. Protean therapies have been investigated in an effort to mitigate the severity of edema and thereby lessen potential complications. This review focuses on those techniques that are employed traditionally and describes a rationale for a comprehensive treatment approach.

    11. You have free access to this content
      Conservative approaches to lymphedema treatment (pages 2828–2832)

      Margaret E. Rinehart-Ayres

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2828::AID-CNCR34>3.0.CO;2-T

      An overview is provided of the conservative treatment of lymphedema from the time of breast carcinoma diagnosis through postoperative treatment.

    12. You have free access to this content
      The treatment of lymphedema (pages 2833–2834)

      Ethel Földi

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2833::AID-CNCR35>3.0.CO;2-3

      The method of choice in the treatment of breast carcinoma treatment-related lymphedema is complex decongestive physiotherapy. Its mode of action and the prerequisites of success (dosage, etc.) are discussed.

    13. You have free access to this content
      The physical treatment of upper limb edema (pages 2835–2839)

      Oliver Leduc, Albert Leduc, Pierre Bourgeois and Jean-Paul Belgrado

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2835::AID-CNCR36>3.0.CO;2-V

      • original image
      • original image
      • original image
      • original image

      Two hundred twenty female patients with upper limb lymphedema received physical treatment. The largest change in lymphedema volume diminution occurred during the first week.

    14. You have free access to this content
      The vodder school: The vodder method (pages 2840–2842)

      Renato G. Kasseroller

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2840::AID-CNCR37>3.0.CO;2-5

      The Vodder School offers professional education for health care providers in combined decongestive physical treatment based on research and proven medical techniques. The emphasis is on perfect manual technique, with a medical background. This education program guarantees the training of high level therapists for the best treatment of patients with consistently better results; the better result is also the most cost-effective result.

    15. You have free access to this content
      Treatment for lymphedema of the arm-The Casley-Smith method : A noninvasive method produces continued reduction (pages 2843–2860)

      Judith R. Casley-Smith, Marvin Boris, Stanley Weindorf and Bonnie Lasinski

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2843::AID-CNCR38>3.0.CO;2-U

      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image
      • original image

      Lymphedema of the arm can and should be treated by noninvasive therapy. A successful result and continuance of reduction is achieved.

    16. You have free access to this content
      Complete decongestive physiotherapy and the lerner lymphedema services academy of lymphatic studies (the lerner school) (pages 2861–2863)

      Robert Lerner

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2861::AID-CNCR39>3.0.CO;2-V

      Complete decongestive physiotherapy has rapidly become the treatment of choice for chronic lymphedema patients. The author describes the contributions to this turn of events made by the training school and clinics he established in order to make this therapy available to American lymphedema patients.

    17. You have free access to this content
      Current status of education and treatment resources for lymphedema (pages 2864–2868)

      Saskia R. J. Thiadens

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2864::AID-CNCR40>3.0.CO;2-B

      • original image
      • original image

      Secondary lymphedema related to breast carcinoma has recently become a recognized and acceptable medical diagnosis, despite continuing ignorance and resistance within much of the U.S. medical community. Although over the past few years there has been a gradual increase in the scope and availability of treatment options for lymphedema, there remains a great need for education and awareness building among health care professionals and patients in the U.S.

    18. You have free access to this content
      Lymphedema management training for physical therapy students in the united states (pages 2869–2873)

      Elizabeth Augustine, Matthew Corn and Jerome Danoff

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2869::AID-CNCR41>3.0.CO;2-U

      • original image

      The results from a recent survey indicate that U.S. physical therapy students are being instructed in multiple modalities for lymphedema management. Modalities include lymphatic massage, low-stretch compression bandaging, exercises, compression pumps, and compression garments.

    19. You have free access to this content
      Lymphedema: Patient and provider education : Current status and future trends (pages 2874–2876)

      Carolyn D. Runowicz

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2874::AID-CNCR42>3.0.CO;2-4

      The current status of patient and provider education about lymphedema is reviewed. Future trends and strategies are recommended.

    20. You have free access to this content
      Workgroup I : Treatment of the Axilla with surgery and radiation-preoperative and postoperative risk assessment (pages 2877–2879)

      A. Marilyn Leitch, Allen G. Meek, Robert A. Smith, Marvin Boris, Pierre Bourgeois, Susan Higgins, Peter I. Pressman, John Stevens and Randy E. Stevens

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2877::AID-CNCR43>3.0.CO;2-T

      Although axillary lymph node dissection (ALND) is currently the standard of care for the management of patients with invasive breast carcinoma, it can be avoided in certain cases in which the lesions are low risk. For those patients for whom ALND is indicated, new surgical approaches as well as greater care and attention to detail with current approaches to surgery and radiation to the axilla may reduce the risk of posttreatment lymphedema.

    21. You have free access to this content
      Workgroup II : Patient education-pre- and posttreatment (pages 2880–2881)

      Carolyn D. Runowicz, Steven D. Passik, Danette Hann, Anthony Berson, Helena Chang, Kay Makar, Roberta Moss, Janet Osuch, Jeanne D. Petrek and Anne-Marie Vaillant-Newman

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2880::AID-CNCR44>3.0.CO;2-9

      Breast cancer patients should receive pre- and posttreatment education about lymphedema. Pretreatment education interventions should be aimed at awareness about the risks of lymphedema and set the stage for posttreatment education, which should focus on prevention and symptom awareness.

    22. You have free access to this content
      Workgroup III : Diagnosis and management of lymphedema (pages 2882–2885)

      Stanley G. Rockson, Linda T. Miller, Ruby Senie, Michael J. Brennan, Judith R. Casley-Smith, Ethel Földi, Michael Földi, Gail L. Gamble, Renato G. Kasseroller, Albert Leduc, Robert Lerner, Peter S. Mortimer, Sandra A. Norman, Chester L. Plotkin, Margaret E. Rinehart-Ayres and Arnold L. Walder

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2882::AID-CNCR45>3.0.CO;2-0

      The purpose of this workshop was to derive a consensus statement regarding the diagnosis and treatment of lymphedema following breast carcinoma therapy. There was consensus on the importance of the patient's subjective presentation with early changes; the importance of early management of patients during the first months after breast carcinoma therapy; and the importance of a multidisciplinary approach to the therapy of lymphedema, with differentiation among those modalities that achieve volume reduction of the involved limb from those that maintain long term beneficial therapeutic effects.

    23. You have free access to this content
      Workgroup IV : Lymphedema treatment resources-professional education and availability of patient services (pages 2886–2887)

      Darlene R. Walley, Elizabeth Augustine, Debbie Saslow, Sherry Bailey, Eunice Jeffs, Bonnie Lasinski, JoAnn Plotkin and Maye Walker

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2886::AID-CNCR46>3.0.CO;2-M

      Health care providers are poorly informed about lymphedema, often do not recognize early signs and symptoms, and are unaware of the availability of treatment in their community. This workgroup concluded that there was a critical need to provide guidance about lymphedema to health care providers, insurers, and breast carcinoma survivors, especially its early signs and symptoms, and to increase the availability of treatment resources.

    24. You have free access to this content
      Workgroup V : Collaboration and advocacy (pages 2888–2890)

      Myrna Candeira, William Schuch, Laura Greiner, Lisa Buckley, Heather Gold, Amy Langer, Beverly McKane, Michele Melin, Marsha Oakley, Joann Schellenbach, Anne Schuch, Saskia R. J. Thiadens, Ginny Thompson and Carin Upstill

      Version of Record online: 9 NOV 2000 | DOI: 10.1002/(SICI)1097-0142(19981215)83:12B+<2888::AID-CNCR47>3.0.CO;2-D

      The workgroup concluded that the collaborative efforts of people and organizations with different skills and strengths are necessary to create innovative solutions to the complex problems of lymphedema. The workgroup identified advocacy opportunities in the areas of research, public and professional education, insurance coverage, and legislation.

SEARCH

SEARCH BY CITATION