| Abstract [eng] |
Breast cancer-related upper extremity lymphedema is one of the most common long-term complications following breast cancer treatment. It develops due to impaired lymphatic drainage after surgical and radiotherapeutic interventions and may occur months or even years after therapy. Breast cancer-related upper extremity lymphedema causes chronic swelling, pain, reduced upper limb function, recurrent infections, and significant psychosocial distress. Because breast cancer survival rates are improving, the prevention and effective management of breast cancer-related upper extremity lymphedema has become increasingly important in modern oncological care. Aim: to evaluate available data on breast cancer-related upper extremity lymphedema, including its risk factors, clinical features, diagnostic methods, and treatment approaches. Objectives: 1. To establish the main risk factors contributing to the development of breast cancer-related upper extremity lymphedema after breast cancer treatment. 2. To evaluate clinical manifestations and their impact on the patient’s physical and psychological well-being. 3. To review current diagnostic methods and their effectiveness in detecting early and advanced stages of breast cancer-related upper extremity lymphedema. 4. To assess conservative, surgical, and emerging treatment strategies and their role in improving patient care. Methods: a literature-based analysis was performed using recent scientific publications, systematic reviews, clinical trials, and international guidelines addressing Breast cancer-related upper extremity lymphedema risk factors, pathophysiology, diagnostic criteria, staging system, and treatment outcomes. Results: The most consistent risk factors for Breast cancer-related upper extremity lymphedema were axillary lymph node dissection, regional nodal irradiation, higher body mass index, postoperative infection, and taxane-based chemotherapy. Breast cancer-related upper extremity lymphedema presents with swelling, heaviness, pain, sensory changes, and reduced mobility, often accompanied by anxiety, depression, and impaired body image. Diagnosis is based on clinical examination and limb volume assessment, supported by advanced methods such as bioimpedance spectroscopy, tissue dielectric constant measurements, lymphoscintigraphy, indocyanine green lymphography, and magnetic resonance lymphangiography. Conservative treatment remains the first-line approach, particularly complex decongestive therapy, compression garments, manual lymph drainage, exercise, and skin care. Surgical approaches, including lymphovenous anastomosis, vascularized lymph node transfer, and liposuction, show benefit in selected cases. Preventive strategies, such as surveillance programs and prophylactic lymphatic surgery, demonstrate promising results in high-risk patients. Conclusions: Breast cancer-related upper extremity lymphedema is a multifactorial and chronic condition that significantly reduces quality of life. Early detection, individualized risk stratification, and integrated conservative and surgical management are essential to reduce disease burden and improve long-term outcomes. |
