ABCR  Vol.2 No.4 , October 2013
Lymphedema in the Mastectomy Postoperative Period: An Integrative Literature Review
Abstract: Aims and Objectives: To analyze the evidence available in the literature on the stages during which upper limb lymphedema after mastectomy occurs. Background: Among the adverse effects of breast cancer treatment, lymphedema is the most prevalent. Design: Integrative literature review. Methods: The Latin American and Caribbean Literature on Health Sciences (Literatura Latino-Americana e do Caribe em Ciências da Saúde—LILACS), PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used to select the pertinent studies. The identification data for these studies were summarized, and their methodological features and results were extracted. Results: Regarding the time elapsed since surgery, the highest prevalence of lymphedema corresponded to the late postoperative period, and regarding its severity, mild lymphedema was the most prevalent form. The prevalence was also the highest among the women who were subjected to radical mastectomy and radiotherapy. Conclusions: Many women who are undergoing treatment for breast cancer use strategies for the prevention and control of lymphedema of the upper limb following mastectomy. Relevance to Clinical Practice: The findings of the present study might inform future studies aiming to assess strategies that can be started in the immediate and late postoperative stages to detect lymphedema early and prevent the increase of its prevalence during the late postoperative period after mastectomy.
Cite this paper: Fernandes, A. , Vidal, G. , Moreira, C. , Silva, T. , Valentim, P. and Santos, M. (2013) Lymphedema in the Mastectomy Postoperative Period: An Integrative Literature Review. Advances in Breast Cancer Research, 2, 154-160. doi: 10.4236/abcr.2013.24025.

[1]   Brazil Health Ministry, National Cancer Institute, “2011 Estimates: Incidence of Cancer in Brazil,” Brazil Health Ministry, National Cancer Institute, Rio de Janeiro, 2011.

[2]   M. S. Panobianco, M. V. Parra, A. M. Almeida, M. A. S. Prado and P. A. P. Magalh?es, “Study of the Adherence to Strategies for Prevention and Control of Lymphedema in Women Subjected to Mastectomy,” Escola Anna Nery Revista de Enfermagem, Vol. 13, No. 2, 2009, pp. 161-168.

[3]   L. C. Silva, “Breast Cancer and Psychological Suffering: Aspects Related to Femininity,” Psicologia em Estudo, Maringá, Vol. 13, No. 2, 2008, pp. 231-237.

[4]   L. F. Rezende, A. V. R. Rocha and C. S. Gomes, “Assessment of the Risk Factors for Lymphedema Following Treatment for Breast Cancer,” Journal Vascular Brasileiro, Vol. 9, No. 4, 2010, pp. 233-238.

[5]   R. Freitas Júnior, L. F. J. Ribeiro, L. Taia, D. Kajita, M. V. Fernandes and G. S. Queiroz, “Linfedema em Pacientes Submetidas à Mastectomia Radical Modificada,” Rev. Bras. Ginecol. Obstet., Vol. 23, No. 4, 2001, pp. 205-208.

[6]   H. S. M. Cho, G. C. Davis, J. E. Paek, R. Rao, H. Zhao, X. J. Xie, M. G. Yousef, T. Fedric, D. H. Euhus and M. Leitch, “A Randomised Trial of Nursing Interventions Supporting Recovery of the Postmastectomy Patient,” Journal of Clinical Nursing, Vol. 22, No. 7-8, 2013, pp. 919-929.

[7]   V. Harmer, “Breast Cancer-Related Lymphoedema: Risk Factors and Treatment,” British Journal of Nursing, Vol. 18, No. 3, 2009, pp.166-172.

[8]   A. Bergmann, “Incidence and Risk Factors for Lymphedema after Surgical Treatment of Breast Cancer: Study of a Hospital-Based Cohort,” Brazil Health Ministry, Oswaldo Cruz Foundation, National School of Public Health, Rio de Janeiro, 2005.

[9]   A. Soran, G. Dangelo, M. Begovic, F. Ardic, A. Harlak, S. H. Wieand, V. G. Vogel and R. R. Johnson, “Breast Cancer Related Lymphedema—What Are Significant Predictors and How They Affect the Severity of Lymphedema?” Breast Journal, Vol. 12, No. 6, 2006, pp. 536-543.

[10]   K. D. S. Mendes, R. C. C. P. Silveira and C. M. Galvao, “Integrative Review: A Research Method to Incorporate Evidence in Health and Nursing,” Revista Texto & Contexto de Enfermagem, Florianópolis, Vol. 17, No. 4, 2008, pp. 758-764.

[11]   R. Whittemore and K. Knalf, “The Integrative Review: Update Methodology,” Journal of Advanced Nursing, Vol. 52, No. 5, 2005, pp. 546-553.

[12]   D. L. Pompeo, L. A. Rossi and C. M. Galvao, “Integrative Review: Initial Step in the Process of Validation of the Nursing Diagnosis,” Acta Paulista de Enfermagem, Vol. 22, No. 4, 2009, pp. 434-438.

[13]   M. T. Souza, M. D. Silva and R. Carvalho, “Integrative Review: What It Is and How to Do It,” Revista Einstein, Vol. 8, No. 1, 2010, pp. 102-106.

[14]   W. Kwan, J. Jackson, L. M. Weir, C. Dingee, G. Mcgregor and I. A. Olivotto, “Chronic Arm Morbidity after Curative Breast Cancer Treatment: Prevalence and Impact on Quality of Life,” Journal of Clinical Oncology, Vol. 20, No. 20, 2002, pp. 4242-4248.

[15]   D. Howell and M. Watson, “Evaluation of a Pilot Nurse-Led, Community Based Treatment Programme for Lymphedema,” International Journal Palliative Nursing, Vol. 11, No. 2, 2005, pp. 62-69.

[16]   P. C. Alves, M. C. L. Santos and A. F. C. Fernandes, “Stress and Coping Strategies for Women Diagnosed with Breast Cancer: A Transversal Study,” Online Brazilian Journal of Nursing, Vol. 11, No. 2, 2012, pp. 305-318.

[17]   R. Gartner, M. B. Jensen, L. Kronborg, M. Ewertz, H. Kehlet and N. Kroman, “Self-Reported Arm Lymphedema and Functional Impairment after Breast Cancer Treatment—A Nationwide Study of Prevalence and Associated Factors,” The Breast, Vol. 19, No. 6, 2010, pp. 506-515.

[18]   M. S. Panobianco and M. V. Mamede, “Complications and Intercurrent Events Associated with Edema of the Arm during the First Three Months after Mastectomy,” Revista Latino-Americana de Enfermagem, Vol. 10, No. 4, 2002, pp. 544-551.

[19]   S. V. S. Deo, S. Ray, G. K. Rath, N. K. Shukla, M. Kar, S. Asthana and V. Raina, “Prevalence and Risk Factors for Development of Lymphedema Following Breast Cancer Treatment,” Indian Journal of Cancer, Vol. 41, No. 1, 2004, pp. 8-12.

[20]   M. C. C. Meirelles, M. V. Mamede, L. Souza and M. S. Panobianco, “Assessment of Physical Therapy Techniques in the Treatment of Lymphedema after Breast Surgery in Women,” Revista Brasileira de Fisioterapia. Vol. 10, No. 4, 2006, pp. 393-399.

[21]   I. G. Nesvold, A. Dahl, E. Lokkevik, A. Mengshoel and S. Fossá, “Arm and Shoulder Morbidity in Breast Cancer Patients after Breast—Conserving Therapy versus Mastectomy,” Acta Oncologica, Vol. 47, No. 5, 2008, pp. 835-842.

[22]   A. Bergmann, I. E. Mattos and R. J. Koifman, “Diagnosis of Lymphedema: Analysis of the Methods Used in the Assessment of the Upper Limb after Axillary Lymph Node Dissection for the Treatment of Breast Cancer,” Revista Brasileira de Cancerologia, Vol. 50, No. 4, 2004, pp. 311-320.

[23]   E. G. Turato, “Qualitative and Quantitative Methods in the Field of Health: Definitions, Differences, and Research Subjects,” Revista de Saúde Pública, Vol. 39, No. 3, 2005, pp. 507-514. 10.1590/S0034-89102005000300025

[24]   J. Marrs, “Lymphedema and Implications for Oncology Nursing Practice,” Clinical Journal of Oncology Nursing, Vol. 11, No. 1, 2007, pp. 19-21.

[25]   L. H. Tay, E. Ang and D. Hegney, “Nurses’ Perceptions of the Barriers in Effective Communication within Patient Cancer Adults in Singapore,” Journal of Clinical Nursing, Vol. 21, No. 17-18, 2012, pp. 2647-2658.

[26]   D. C. Hayes, M. Janda, B. Cornish, D. Battistutta and B. Newman, “Lymphedema after Breast Cancer: Incidence, Risks, Factors & Effect on Upper Body Function,” Journal of Clinical Oncology, Vol. 26, No. 21, 2008, pp. 3536-3542.

[27]   R. B. Jones, J. Pearson, A. J. Cawsey, D. Bental, A. Barrett, J. White and W. H. Gilmour, “Effect of Different Forms of Information Produced for Cancer Patients on Their Use of the Information, Social Support, and Anxiety: Randomized Trial,” British Medical Journal London, Vol. 332, No. 7547, 2006, pp. 942-948.

[28]   T. Schulze, J. Mucke, J. Markwardt, P. M. Schlag and A. Bembenek, “Long-Term Morbidity of Patients with Early Breast Cancer after Sentinel Lymph Node Biopsy Compared to Axillary Lymph Node Dissection,” Journal of Surgical Oncology, Vol. 93, No. 2, 2006, pp.109-119. jso.20406

[29]   C. Kim, D. Kang and J. Park, “A Meta-Analysis of Aerobic Exercise Interventions for Women with Breast Cancer,” Western Journal of Nursing Research, Vol. 31, No. 4, 2009, pp. 437-461. 1177/0193945908328473