Which are the best conservative interventions for lymphoedema after breast cancer surgery?

Lymphoedema is a common complication of breast cancer surgery with or without adjuvant cancer treatments.1 Fluid accumulates because of damage to the lymphatic system, most commonly after axillary lymph node dissection. Box 1 shows factors associated with lymphoedema. Swelling is commonly in the arm but can involve the chest or back; it can result in pain, dysfunction, and disturbance of body image.

Nearly 1 in 5 women who survive breast cancer develops lymphoedema within two years of diagnosis or surgery, with the incidence increasing with time.13 In recent years, sentinel lymph node biopsy has been implemented as standard care and has greatly reduced the incidence of lymphoedema. This means that women with clinically positive lymph nodes undergo the higher risk axillary lymph node dissection, but others can avoid the procedure.

In this article the interventions are discussed and will help you decide which treatment is best for your patients.