In this review:
Interventions for Breast Cancer-Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA
(PTJ, June 2020)
APTA Oncology has published its first major treatment-related clinical practice guideline — a resource on treatment of lymphedema related to breast cancer targeted specifically at the PT's role. Following up the academy’s 2017 guideline on diagnosis of upper quadrant lymphedema related to cancer, the new CPG structures its recommendations around what authors call "the care trajectory" and cites particularly strong evidence supporting exercise for those at risk for or in early stages of breast cancer-related lymphedema, or BCRL, and careful, patient-focused compression interventions when appropriate.
To weed out postoperative swelling, the academy's CPG panel built its review around lymphedema when present more than three months past postsurgical management. While the original intention of the effort was to create guidelines that addressed all upper quadrant lymphedema, it became clear few clinical trials were available that dealt with the condition outside of BCRL. In the end, the CPG focused on 209 BCRL studies conducted between January 2000 and March 2019, from an original review of 1,517 articles.
APTA members Claire Davies, PT, PhD; Kimberly Levenhagen, PT, DPT; Kathryn Ryans, PT, DPT; Marisa Perdomo PT, DPT, MS; and Laura Gilchrist, PT, PhD, authored the guideline.