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Lymphoedema — SCE Medical Oncology MCQ

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EasyBreast CancerLymphoedemaSCE Medical Oncology

A 60-year-old woman with breast cancer notices progressive arm swelling 18 months after axillary lymph node dissection. The arm is 3 cm larger in circumference than the contralateral side. There is no evidence of recurrence. What is the diagnosis and first-line management?

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Correct answer: D — Breast cancer-related lymphoedema — compression garments, manual lymphatic drainage (complex decongestive therapy)

Breast cancer-related lymphoedema (BCRL) affects approximately 20-30% of patients after ALND (less after SLNB). It results from disrupted lymphatic drainage. Management follows a stepwise approach: (1) complex decongestive therapy (CDT: manual lymphatic drainage, compression garments, skin care, exercise), (2) intermittent pneumatic compression, (3) surgical options for refractory cases (lymphovenous anastomosis, lymph node transfer). Prompt intervention improves outcomes. Cellulitis prophylaxis and skin care education are essential.

Reference: NICE NG101 Breast cancer; BLS/LSN Lymphoedema guidelines; ESMO Survivorship