Laila Samiian, MD, Andrew M. Kaunitz, MD reviewing Ferguson CM et al. J Clin Oncol 2016 Mar 1.

Study debunks conventional guidance about lymphedema prevention.

To lower risk for breast cancer–related lymphedema (BCRL) and cellulitis, guidelines advise women to avoid blood draws, injections, and blood pressure (BP) assessment in the at-risk (ipsilateral) arm and to wear a compression sleeve during air travel after treatment; however, strictly following these recommendations can be an onerous source of stress and anxiety. Investigators at one academic center serially assessed bilateral arm volume in women with newly diagnosed breast cancer; at each visit, participants also completed surveys about whether they had engaged in nonprecautionary behaviors. Patients at this center are not routinely advised to avoid such activities.

Among 632 women (median age at diagnosis, 52; median body-mass index [BMI], 26 kg/m2; 92% white), median follow-up was 24 months. Overall, 71% of participants underwent sentinel node biopsy and 74% had two to six measurements. Among some 2900 survey responses, rates of nonprecautionary events were 2% (injections), 8% (blood draws), 16% (BP measurements), and 30% (air travel). In an aggregate of 3041 measurements, no significant association was found between increased arm volume and occurrence of blood draws, injections, and number or duration of flights. Multivariate analysis showed that significant increases in arm volume were associated with BMI ≥25 and prior axillary lymph node dissection, regional lymph node radiation, and cellulitis.

CITATION(S):

Ferguson CM et al. Impact of ipsilateral blood draws, injections, blood pressure measurements, and air travel on the risk of lymphedema for patients treated for breast cancer. J Clin Oncol 2016 Mar 1; 34:691.

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