METHODS
To establish the evidence base for care of breast cancer patients with arm
edema, we reviewed existing guidelines and literature. Published guidelines for
breast cancer care primarily address treatment aspects, rather than long-term care
for morbid conditions secondary to treatment. Of 17 published guidelines (13–
29) for breast cancer care, only two (14,20) addressed care of patients with
treatment-related lymphedema.
A total of 10 MEDLINE® literature search strategies were used. Three initial
literature search strategies for articles on breast cancer-related arm morbidity
covered 1993–1999 and resulted in 127 entries associated with 96 unique
articles. The three search strategies were as follows: 1) (subject: mastectomy)
AND (subject: activities of daily living OR lymphedema OR arm) OR (keyword:
arm) (50 entries); 2) (subject: breast neoplasms, radiotherapy OR radiotherapy,
adjuvant) AND (subject: activities of daily living OR lymphedema OR arm) OR
(keyword: arm) (11 entries); and 3) (subject: breast neoplasms) AND (subject:
activities of daily living OR lymphedema OR arm) AND (keyword: function or
functional) (66 entries).
Seven subsequent search strategies for articles on lymphedema covered 1985–
1999 and resulted in 381 entries associated with 311 unique articles. The strategies
were as follows: 1) (subject: breast neoplasms) AND (keyword: lymphedema
treatment) (20 entries); 2) (keyword: post-mastectomy lymphedema OR