Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in context
Summary: Background: Developing strategies to prevent breast cancer-related arm lymphoedema (BCRAL) is a critical unmet need because there are no effective interventions to eradicate it once it reaches a chronic state. Certain strategies such as prospective surveillance programs and prophylactic ly...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-02-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537024000208 |
| _version_ | 1827360840208089088 |
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| author | Henry C.Y. Wong Matthew P. Wallen Adrian Wai Chan Narayanee Dick Pierluigi Bonomo Monique Bareham Julie Ryan Wolf Corina van den Hurk Margaret Fitch Edward Chow Raymond J. Chan Muna AlKhaifi Belen Alonso Alvarez Suvam Banerjee Kira Bloomquist Pierluigi Bonomo Pinar Borman Yolande Borthwick Dominic Chan Sze Man Chan Yolanda Chan Ngan Sum Jean Cheng J. Isabelle Choi Edward Chow Yin Ping Choy Kimberly Corbin Elizabeth Dylke Pamela Hammond Satoshi Hirakawa Kimiko Hirata Shing Fung Lee Marianne Holt Peter Johnstone Yuichiro Kikawa Deborah Kirk Haruru Kotani Carol Kwok Jessica Lai Mei Ying Lim Michael Lock Brittany Lorden Page Mack Stefano Magno Icro Meattini Gustavo Nader Marta Margaret McNeely Tammy Mondry Luis Enrique Lopez Montoya Mami Ogita Misato Osaka Stephanie Phan Philip Poortmans Bolette Skjødt Rafn Abram Recht Agata Rembielak Angela Río-González Jolien Robijns Naoko Sanuki Charles B. Simone, II Mateusz Spałek Kaori Tane Luiz Felipe Nevola Teixeira Mitsuo Terada Mark Trombetta Kam Hung Wong Katsuhide Yoshidome |
| author_facet | Henry C.Y. Wong Matthew P. Wallen Adrian Wai Chan Narayanee Dick Pierluigi Bonomo Monique Bareham Julie Ryan Wolf Corina van den Hurk Margaret Fitch Edward Chow Raymond J. Chan Muna AlKhaifi Belen Alonso Alvarez Suvam Banerjee Kira Bloomquist Pierluigi Bonomo Pinar Borman Yolande Borthwick Dominic Chan Sze Man Chan Yolanda Chan Ngan Sum Jean Cheng J. Isabelle Choi Edward Chow Yin Ping Choy Kimberly Corbin Elizabeth Dylke Pamela Hammond Satoshi Hirakawa Kimiko Hirata Shing Fung Lee Marianne Holt Peter Johnstone Yuichiro Kikawa Deborah Kirk Haruru Kotani Carol Kwok Jessica Lai Mei Ying Lim Michael Lock Brittany Lorden Page Mack Stefano Magno Icro Meattini Gustavo Nader Marta Margaret McNeely Tammy Mondry Luis Enrique Lopez Montoya Mami Ogita Misato Osaka Stephanie Phan Philip Poortmans Bolette Skjødt Rafn Abram Recht Agata Rembielak Angela Río-González Jolien Robijns Naoko Sanuki Charles B. Simone, II Mateusz Spałek Kaori Tane Luiz Felipe Nevola Teixeira Mitsuo Terada Mark Trombetta Kam Hung Wong Katsuhide Yoshidome |
| author_sort | Henry C.Y. Wong |
| collection | DOAJ |
| description | Summary: Background: Developing strategies to prevent breast cancer-related arm lymphoedema (BCRAL) is a critical unmet need because there are no effective interventions to eradicate it once it reaches a chronic state. Certain strategies such as prospective surveillance programs and prophylactic lymphatic reconstruction have been reported to be effective in clinical trials. However, a large variation exists in practice based on clinician preference, organizational standards, and local resources. Methods: A two-round international Delphi consensus process was performed from February 27, 2023 to May 25, 2023 to compile opinions of 55 experts involved in the care and research of breast cancer and lymphoedema on such interventions. Findings: Axillary lymph node dissection, use of post-operative radiotherapy, relative within-arm volume increase one month after surgery, greater number of lymph nodes dissected, and high body mass index were recommended as the most important risk factors to guide selection of patients for interventions to prevent BCRAL. The panel recommended that prospective surveillance programs should be implemented to screen for and reduce risks of BCRAL where feasible and resources allow. Prophylactic compression sleeves, axillary reverse mapping and prophylactic lymphatic reconstruction should be offered for patients who are at risk for developing BCRAL as options where expertise is available and resources allow. Recommendations on axillary management in clinical T1–2, node negative breast cancer patients with 1–2 positive sentinel lymph nodes were also provided by the expert panel. Routine axillary lymph node dissection should not be offered in these patients who receive breast conservation therapy. Axillary radiation instead of axillary lymph node dissection should be considered in the same group of patients undergoing mastectomy. Interpretation: An individualised approach based on patients' preferences, risk factors for BCRAL, availability of treatment options and expertise of the healthcare team is paramount to ensure patients at risk receive preventive interventions for BCRAL, regardless of where they are receiving care. Funding: This study was not supported by any funding. RJC received investigator grant support from the Australian National Health and Medical Research Council (APP1194051). |
| first_indexed | 2024-03-08T06:54:12Z |
| format | Article |
| id | doaj.art-a4492596283245c89816027c97e264da |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-03-08T06:54:12Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-a4492596283245c89816027c97e264da2024-02-03T06:39:09ZengElsevierEClinicalMedicine2589-53702024-02-0168102441Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in contextHenry C.Y. Wong0Matthew P. Wallen1Adrian Wai Chan2Narayanee Dick3Pierluigi Bonomo4Monique Bareham5Julie Ryan Wolf6Corina van den Hurk7Margaret Fitch8Edward Chow9Raymond J. Chan10Muna AlKhaifiBelen Alonso AlvarezSuvam BanerjeeKira BloomquistPierluigi BonomoPinar BormanYolande BorthwickDominic ChanSze Man ChanYolanda ChanNgan Sum Jean ChengJ. Isabelle ChoiEdward ChowYin Ping ChoyKimberly CorbinElizabeth DylkePamela HammondSatoshi HirakawaKimiko HirataShing Fung LeeMarianne HoltPeter JohnstoneYuichiro KikawaDeborah KirkHaruru KotaniCarol KwokJessica LaiMei Ying LimMichael LockBrittany LordenPage MackStefano MagnoIcro MeattiniGustavo Nader MartaMargaret McNeelyTammy MondryLuis Enrique Lopez MontoyaMami OgitaMisato OsakaStephanie PhanPhilip PoortmansBolette Skjødt RafnAbram RechtAgata RembielakAngela Río-GonzálezJolien RobijnsNaoko SanukiCharles B. Simone, IIMateusz SpałekKaori TaneLuiz Felipe Nevola TeixeiraMitsuo TeradaMark TrombettaKam Hung WongKatsuhide YoshidomeDepartment of Oncology, Princess Margaret Hospital, Hong Kong S.A.R, ChinaCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, AustraliaDepartment of Clinical Oncology, Tuen Mun Hospital, Hong Kong S.A.R, ChinaCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, AustraliaDepartment of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, ItalyFlinders Health Medical Research Consumer Advisory Board, Flinders University, South Australia, Australia; South Australia Lymphoedema Compression Garment Subsidy Advisory Group, South Australia, AustraliaDepartment of Radiation Oncology, University of Rochester, New York, USAR&D Department, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, NetherlandsLawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, CanadaDepartment of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, CanadaCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Corresponding author. Caring Futures Institute, College of Nursing and Health Sciences, Sturt Campus, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia.Summary: Background: Developing strategies to prevent breast cancer-related arm lymphoedema (BCRAL) is a critical unmet need because there are no effective interventions to eradicate it once it reaches a chronic state. Certain strategies such as prospective surveillance programs and prophylactic lymphatic reconstruction have been reported to be effective in clinical trials. However, a large variation exists in practice based on clinician preference, organizational standards, and local resources. Methods: A two-round international Delphi consensus process was performed from February 27, 2023 to May 25, 2023 to compile opinions of 55 experts involved in the care and research of breast cancer and lymphoedema on such interventions. Findings: Axillary lymph node dissection, use of post-operative radiotherapy, relative within-arm volume increase one month after surgery, greater number of lymph nodes dissected, and high body mass index were recommended as the most important risk factors to guide selection of patients for interventions to prevent BCRAL. The panel recommended that prospective surveillance programs should be implemented to screen for and reduce risks of BCRAL where feasible and resources allow. Prophylactic compression sleeves, axillary reverse mapping and prophylactic lymphatic reconstruction should be offered for patients who are at risk for developing BCRAL as options where expertise is available and resources allow. Recommendations on axillary management in clinical T1–2, node negative breast cancer patients with 1–2 positive sentinel lymph nodes were also provided by the expert panel. Routine axillary lymph node dissection should not be offered in these patients who receive breast conservation therapy. Axillary radiation instead of axillary lymph node dissection should be considered in the same group of patients undergoing mastectomy. Interpretation: An individualised approach based on patients' preferences, risk factors for BCRAL, availability of treatment options and expertise of the healthcare team is paramount to ensure patients at risk receive preventive interventions for BCRAL, regardless of where they are receiving care. Funding: This study was not supported by any funding. RJC received investigator grant support from the Australian National Health and Medical Research Council (APP1194051).http://www.sciencedirect.com/science/article/pii/S2589537024000208PreventionBreast cancer related arm lymphoedemaDelphi consensus |
| spellingShingle | Henry C.Y. Wong Matthew P. Wallen Adrian Wai Chan Narayanee Dick Pierluigi Bonomo Monique Bareham Julie Ryan Wolf Corina van den Hurk Margaret Fitch Edward Chow Raymond J. Chan Muna AlKhaifi Belen Alonso Alvarez Suvam Banerjee Kira Bloomquist Pierluigi Bonomo Pinar Borman Yolande Borthwick Dominic Chan Sze Man Chan Yolanda Chan Ngan Sum Jean Cheng J. Isabelle Choi Edward Chow Yin Ping Choy Kimberly Corbin Elizabeth Dylke Pamela Hammond Satoshi Hirakawa Kimiko Hirata Shing Fung Lee Marianne Holt Peter Johnstone Yuichiro Kikawa Deborah Kirk Haruru Kotani Carol Kwok Jessica Lai Mei Ying Lim Michael Lock Brittany Lorden Page Mack Stefano Magno Icro Meattini Gustavo Nader Marta Margaret McNeely Tammy Mondry Luis Enrique Lopez Montoya Mami Ogita Misato Osaka Stephanie Phan Philip Poortmans Bolette Skjødt Rafn Abram Recht Agata Rembielak Angela Río-González Jolien Robijns Naoko Sanuki Charles B. Simone, II Mateusz Spałek Kaori Tane Luiz Felipe Nevola Teixeira Mitsuo Terada Mark Trombetta Kam Hung Wong Katsuhide Yoshidome Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in context EClinicalMedicine Prevention Breast cancer related arm lymphoedema Delphi consensus |
| title | Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in context |
| title_full | Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in context |
| title_fullStr | Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in context |
| title_full_unstemmed | Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in context |
| title_short | Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendationsResearch in context |
| title_sort | multinational association of supportive care in cancer mascc clinical practice guidance for the prevention of breast cancer related arm lymphoedema bcral international delphi consensus based recommendationsresearch in context |
| topic | Prevention Breast cancer related arm lymphoedema Delphi consensus |
| url | http://www.sciencedirect.com/science/article/pii/S2589537024000208 |
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