Prospective protocol for lymphedema education and surveillance in a breast health center

• Published in: Clinical journal of oncology nursing Vol. 18 Suppl; no. 5; pp. 27 - 31
• Main Authors: Haley-Emery, Mary, Schmitz-Johnson, Wendy
• Format: Journal Article
• Language: English
• Published: United States Oncology Nursing Society 01.10.2014
• Subjects: Breast cancer; Breast Neoplasms - complications; Cancer therapies; Care and treatment; Clinical Protocols; Development and progression; Diagnosis; Digital Object Identifier; Education; Evidence-based nursing; Female; Humans; Intervention; Lymphatic system; Lymphedema; Lymphedema - complications; Lymphedema - nursing; Measurement techniques; Nursing; Nursing Assessment; Patient Education as Topic - methods; Patient outcomes; Patients; Pilot Projects; Prospective Studies; Quality of life; Sentinel health events; Surveillance; breast cancer; lymphedema; surveillance
• ISSN: 1092-1095; 1538-067X
• DOI: 10.1188/14.CJON.S2.27-31

Participation in the ONS Foundation-supported Breast Cancer Survivorship Quality Measures Set pilot study indicated less than optimal assessment and educational practices for lymphedema surveillance at one author's institution. This finding led staff to expand on nursing practice associated with lymphatic dysfunction and to propose a surveillance tool that is easy to use in a busy clinical setting. Based on current trends in lymphatic surveillance, arm measurements were used to assess for relative percentage differences compared to baseline. The referral threshold for lymphedema diagnosis was set at a 10% relative difference in circumferential measurements, pre- and postoperatively, as well as during the survivorship period. Enhanced education efforts, inclusive of staff and patients, will be established throughout the continuum of care. As lymphedema research and standard of care consensus become established, this surveillance model will be adapted in accordance with evidence-based practice guidelines.