American Cancer Society. Cancer Facts & Figures 2023. Available at 3. Accessed 6 June 2023.

Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69:363–85.

Article  PubMed  Google Scholar 

DiSipio T, Rye S, Newman B, Haye S. Incidence of unilateral arm lymphedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 2013;14:500–15.

Article  PubMed  Google Scholar 

Armer JM, Ballman KV, McCall L, et al. Lymphedema symptoms and limb measurement changes in breast cancer survivors lymphedema: results of American College of Surgeons Oncology Group (ACOSOG) Z1071 (Alliance) substudy. Support Care Cancer. 2019;27:495–503.

Article  PubMed  Google Scholar 

Galimberti V, Cole BF, Zurrida S, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23–01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14:297–305.

Article  PubMed  PubMed Central  Google Scholar 

Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569–75.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Donker M, van Tienhoven G, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981–22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15:1303–10.

Article  PubMed  PubMed Central  Google Scholar 

Mcduff SGR, Mina AI, Brunelle CL, et al. Timing of lymphedema after treatment for breast cancer: when are patients most at risk? Int J Radiat Oncol Biol Phys. 2019;103:62–70. This prospective study investigated incidence, risk factors, time course of BCRL in a cohort of patients treated with modern therapies for breast cancer.

Article  PubMed  Google Scholar 

Naoum E, Roberts S, Brunelle CL, et al. Quantifying the impact of axillary surgery and nodal irradiation on breast cancer-related lymphedema and local tumor control: long-term results from a prospective screening trial. J Clin Oncol. 2020;38:3430–8.

Article  PubMed  PubMed Central  Google Scholar 

McLaughlin SA, Staley AC, Vicini F, et al. Considerations for clinicians in the diagnosis, prevention, and treatment of breast cancer-related lymphedema: recommendations from a multidisciplinary expert ASBrS panel: part 1: definitions, assessments, education, and future directions. Ann Surg Oncol. 2017;24:2818–26.

Article  PubMed  Google Scholar 

National Lymphedema Network Medical Advisory Committee. Position statement of the national lymphedema network: screening and early detection of breast cancer-related lymphedema: The Imperative; 2011. Position Papers — National Lymphedema Network - Empowering the Lymphedema Community (lymphnet.org). Accessed 20 May 2022.

Denlinger CS, Sanft T, Moslehi JJ, et al. NCCN guidelines insights: survivorship, Version 2.2020. J Natl Compr Canc Netw. 2020;18:1016–23.

Article  PubMed  PubMed Central  Google Scholar 

International Society of Lymphology (I SL). The diagnosis and treatment of peripheral lymphedema. Consensus Document of the International Society of Lymphology. Lymphology. 2020;2020(53):3–19.

Google Scholar 

Kilbreath SL, Lee MJ, Refshauge KM, Beith JM, Ward LC, Simpson JM, et al. Transient swelling versus lymphoedema in the first year following surgery for breast cancer. Support Care Cancer. 2013;21:2207–15.

Article  PubMed  Google Scholar 

Johnson AR, Granoff MD, Lee BT, et al. The impact of taxane-based chemotherapy on the lymphatic system. Ann Plast Surg. 2019;82:S173–8.

Article  CAS  PubMed  Google Scholar 

Swaroop MN, Ferguson CM, Horick NK, et al. Impact of adjuvant taxane-based chemotherapy on development of breast cancer-related lymphedema: results form a large prospective cohort. Breast Cancer Res Tr eat. 2015;151:393–403.

Article  CAS  Google Scholar 

Lee MJ, Beith J, Ward L, Kilbreath S. Lymphedema following taxane-based chemotherapy in women early breast cancer. Lymphat Res Biol. 2014;12:282–8.

Article  CAS  PubMed  Google Scholar 

Mehrara B, Green AK. Lymphedema and obesity: is there a link? Plast Reconstr Surg. 2014;134:154e–60e.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Suami H, Scaglioni MF. Anatomy of the lymphatic system and the lymphosome concept with reference to lymphedema. Semin Plast Surg. 2018;32:5–11.

Article  PubMed  PubMed Central  Google Scholar 

Scallan JP, Zawieja SD, Catorena-Gonzalez JA, Davis MJ. Lymphatic pumping: mechanics, mechanisms, and malfunction. J Physiol. 2016;594:5749–6578.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Breslin JW. Mechanical forces and lymphatic transport. Microvasc Res. 2014;96:46–54.

Article  PubMed  Google Scholar 

Breslin JW, Yang Y, Scallan JP, et al. Lymphatic vessel network structure and physiology. Comp Physiol. 2019;9:207–99.

Google Scholar 

Soran A, Ozmen T, McGuire KP, et al. The importance of detection of subclinical lymphedema for the prevention of breast cancer-related clinical lymphedema after axillary lymph node dissection; a prospective observational study. Lymphat Res Biol. 2014;12:289–94.

Article  PubMed  Google Scholar 

Shah C, Vicini F, Beitsch P, et al. The use of bioimpedance spectroscopy to monitor therapeutic intervention in patients treated for breast cancer related lymphedema. Lymphology. 2013;46:184–92.

CAS  PubMed  Google Scholar 

Rafn BS, Christenen J, Larsen A, Bloomquist K. Prospective surveillance for breast cancer-related arm lymphedema: a systematic review and meta-analysis. J Clin Oncol. 2022;40(9):1009–26.

Article  PubMed  Google Scholar 

Koelmeyer LA, Borotakanics RJ, Alcoros J, et al. Early Surveillance is associated with less incidence and severity of breast cancer-related lymphedema compared with a traditional referral model of care. Cancer. 2019;125:854–62.

Article  PubMed  Google Scholar 

Stout Gergich NL, Pfalzer LA, McGarvey C, et al. Preoperative assessment enables the early diagnosis and successful treatment of lymphedema. Cancer. 2008;112:2809–19.

Article  PubMed  Google Scholar 

Kilgore LJ, Korentager SS, Hangge AN, et al. Reducing breast cancer-related lymphedema (BCRL) through prospective surveillance monitoring using bioimpedance spectroscopy (BIS) and patient directed self-interventions. Ann Surg Oncol. 2008;25:2948–52.

Article  Google Scholar 

Whitworth PW, Shah C, Vicini F, Cooper A. preventing breast cancer-related lymphedema in high-risk patients: the impact of a structured surveillance protocol using bioimpedance spectroscopy. Front Oncol. 2018;8:197.

Article  PubMed  PubMed Central  Google Scholar 

Ridner SH, Dietrich MS, Boyages J et al. A comparison of bioimpedance spectroscopy or tape measure triggered compression intervention in chronic breast cancer lymphedema prevent ion. Lymphatic Res and Biology. 2022. Online ahead of print. This randomized controlled trial investigated BCRL progression rates using volume measurements calculated from tape measure circumference measurements as compared to bioimpedance spectroscopy in BCRL surveillance.

De Vrieze T, Nevelsteen I, Thomis S, et al. What are the economic burden and costs associated with treatment of breast cancer-related lymphoedema? A systematic review. Support Care Cancer. 2020;28:439–49.

Article  PubMed  Google Scholar 

Stout NLN, Pfalzer LLA, Springer B, et al. Breast cancer-related lymphedema: comparing direct costs of a prospective surveillance model and a traditional model of care. Phys Ther. 2012;92:152–63.

Article  PubMed  Google Scholar 

Armer JM, Stewart BR. A comparison of four diagnostic criteria for lymphedema in a post-breast cancer population. Lymphat Res Biol. 2005;208–217.

Ridner SH, Dietrich MS, Spotanski K, et al. A prospective study of L-Dex values in breast cancer patients pretreatment and through 12 months postoperatively. Lymphat Res Biol. 2018;16:435–41.

Article  PubMed  PubMed Central  Google Scholar 

Stout NL, Binkley JM, Schmitz KH, et al. A prospective surveillance model for rehabilitation for women with breast cancer. Cancer. 2012;118(SUPPL.8):2191–200.

Article  PubMed  Google Scholar 

Sun F, Skolny MN, Swaroop MN, et al. The need for preoperative baseline arm measurement to accurately quantify breast cancer related lymphedema. Breast Cancer Res Treat. 2016;157:229–40. This prospective study investigated the importance of baseline temporal measurements as necessary for accurate BCRL quantification and the factors affecting BCRL diagnosis in patients without baseline measurements.

Article  CAS  PubMed  Google Scholar 

Hakan Brorson, Hoijer P. Standardised measurements used to order compression garments can be used to calculate arm volumes to evaluate lymphoedema treatment. J Plast Surg Hand Surg. 2012;46:410–5.

Article  Google Scholar 

Dylke ES, Yee J, Ward LC, et al. Normative volume difference between dominant and nondominant upper limbs in healthy older women. Lymphat Res Biol. 2012;10:182–8.

Article  CAS  PubMed  Google Scholar 

Ancukiewicz M, Miller CL, Skolny MN, et al. Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology. Breast Cancer Res Treat. 2012;135:145–52. This prospective study investigated the role of absolute volume arm changes and relative arm volume changes in the diagnosis of BCRL. The study demonstrated that relative arm volume changes are more accurate for the diagnosis of BCRL as relative volume changes are independent of body size.

Article  PubMed  PubMed Central  Google Scholar 

Roberts SA, Brunelle CL, Gillespie TC, et al. Methods for quantifying breast cancer-related lymphedema in patients undergoing a contralateral prophylactic mastectomy. Lymphology. 2021;51:113–21. This prospective study compared relative volume change to weight adjusted change for quantification of BCRL in patients with unilateral breast cancer who undergo contralateral prophylactic mastectomy.

Google Scholar 

Miller CL, Specht MC, Horick N, et al. A novel, validated method to quantify breast cancer-related lymphedema (BCRL) following bilateral breast surgery. Lymphology. 2013;46:64–74. This study investigated the use of a weight-adjusted volume change formula (WAC) for the diagnosis of BCRL in patients who undergo bilateral breast and axillary surgery.

CAS  PubMed  Google Scholar 

Hayes S, Cornish B, Newman B. Comparison of methods to diagnose lymphedema among breast cancer survivors: 6-month follow-up. Breast Cancer Res Treat. 2005;89:221–6.

Article  PubMed  Google Scholar 

Levenhagen K, Davies C, Perdomo M, et al. Diagnosis of upper quadrant lymphedema secondary to cancer: clinical practice guideline from the Oncology Section of the American Physical Therapy Association. Phys Ther. 2017;97:729–45.