Prospective arm-volume surveillance to catch and reverse lymphoedema early
Arm swelling after breast cancer surgery is common and lifelong once established, but if caught early with simple measurements and treated with a sleeve, most cases can be prevented from becoming permanent.
Breast cancer-related lymphoedema affects a large minority of patients who have axillary surgery or radiotherapy. Prospective surveillance with bioimpedance spectroscopy or arm-volume measurement, and early compression when subclinical change is detected, reduced progression to chronic lymphoedema substantially in a randomised trial (PREVENT). Surveillance is rarely implemented. Making it a standard component of breast cancer follow-up is inexpensive.
- Survivorship and late effects are neglected · Tens of millions of people live after cancer with heart damage, infertility, second cancers and fear, and few services.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
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