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Nurses key to lymphoedema control

Early nurse-led interventions can significantly improve outcomes for breast cancer patients with lymphoedema, say US nurse researchers.

The condition, due to build-up of lymph fluid in the tissues after surgery or radiotherapy, causes swellings that occur immediately or years later.

According to the charity Breast Cancer Care, up to 38% of women having treatment for breast cancer are affected.

The US researchers reviewed 20 years of data on lymphoedema. They said that early identification and treatment, education about triggers and symptoms, and routine assessments were vital in decreasing incidence and managing the condition.

Lead author Mattie McDowell, breast cancer research nurse at Texas University, said: ‘Nurses are on the frontline and may hold the key in proactively preventing lymphoedema in many patients.’

Dawn Symonds, lead breast cancer nurse for Buckinghamshire Hospitals NHS Trust, said: ‘Central node biopsies – where only one to two lymph nodes are removed – have significantly reduced risk of lymphoedema in the UK.

‘But flagging up high-risk patients is still essential to lymphoedema prevention,’ she added. ‘Wearing a wristband, or putting stickers on a patient’s notes, can help reduce the risk as it warns nursing staff not to take blood pressure or insert a cannula in the affected arm.’

Vickki Harmer, clinical nurse specialist in the breast care unit at St Mary’s Hospital, West London, added: ‘Because lymphoedema can still occur years after surgery, continued surveillance is very important.

‘Patients also need practical advice to help manage the condition, such as factsheets on how to exercise and massage the arm, how to wear pressure sleeves and how to avoid damage to the skin.’

The study findings were presented this month at a US Oncology Nurses Society conference in Phildelphia.

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