Prevention of arm lymphoedema after breast cancer: what health professionals need to know

Arm lymphoedema after breast cancer treatment is preventable and can be reversible if caught early. Many risk factors are modifiable and lifestyle changes adopted by patients can reduce incidence substantially. Education in risk reduction is a central tenet of specialist lymphoedema prevention programmes, however, non-specialist healthcare professionals commonly get requests for instructions and advice by breast cancer patients. In general, healthcare professionals receive inadequate education and training on the lymphatic system and may feel ill-equipped to issue advice, despite being best placed to provide it. Low-risk patients are unlikely to require lifestyle modifications to prevent lymphoedema once the treatment phase is over, unless cording or adherent axillary scars persist, but high- and medium-risk patients need education in lifetime prevention and self-treatment strategies. This article discusses risk stratification and outlines self-management strategies for at-risk cohorts. By gaining knowledge about lymphoedema prevention, healthcare professionals can confidently guide their patients on how to prevent lymphoedema and its physical and psychological sequelae.