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Practice Point
Lymphoedema risk assessment and referral
Patients at higher risk of lymphoedema (e.g. those in whom axillary clearance or axillary radiation therapy is planned, or patients with lymphatic insufficiency) should be referred to a lymphoedema therapist for assessment prior to breast cancer treatment, and for regular monitoring after breast cancer treatment. Bioimpedance measurements may be part of the clinical assessment.
Women with breast cancer [should be informed about the risk of developing lymphoedema following surgery or radiotherapy] and should be offered rapid access to a specialist lymphoedema service (Level of evidence – high)
Ensure that people with breast cancer who develop lymphoedema have rapid access to a specialist lymphoedema service
The desirable effects of an intervention clearly outweigh the undesirable effects (the intervention is to be put into practice), or the undesirable effects of an intervention clearly outweigh the desirable effects (the intervention is not to be put into practice)
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How this guidance was developed
This practice point was developed using an expert consensus process. The practice point was informed by two source recommendations, one from the KCE 2013 guidelines (Belgium) that was graded ‘Strong’ using GRADE methods by the source guideline authors, and one from NICE 2018 guidelines (evidence review to 2007, not updated in 2017) that used wording ('Ensure') indicative of a strong recommendation. The practice point was also informed by the principles of lymphoedema identification and management from the NSW Health, Agency for Clinical Innovation (2018).
Related guidance by topic
Lymphoedema risk assessment and referral
Practice Point
Patients at higher risk of lymphoedema (e.g. those in whom axillary clearance or axillary radiation therapy is planned, or patients with lymphatic insufficiency) should be referred to a lymphoedema therapist for assessment prior to breast cancer treatment, and for regular monitoring after breast cancer treatment. Bioimpedance measurements may be part of the clinical assessment.
Principles in action
Patient-centred care
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Supportive care
Useful Links
This practice point was developed using an expert consensus process. The practice point was informed by two source recommendations, one from the KCE 2013 guidelines (Belgium) that was graded ‘Strong’ using GRADE methods by the source guideline authors, and one from NICE 2018 guidelines (evidence review to 2007, not updated in 2017) that used wording ('Ensure') indicative of a strong recommendation. The practice point was also informed by the principles of lymphoedema identification and management from the NSW Health, Agency for Clinical Innovation (2018).
Related guidance by topic
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