Date of Graduation

Summer 8-10-2018

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Background: Lymphedema is a common complication of breast cancer treatment. And while breast cancer survivors are at an increased risk of developing lymphedema, there are various risk factors that, if avoided, might limit the incidence of arm swelling. A few national organizations have recommended that patients avoid blood pressure measurements on the affected arm. The purpose of this systematic review is to determine whether this burden is evidence-based or if it is causing unnecessary health anxiety.

Methods: An exhaustive search of available medical literature was performed using MEDLINE-PubMed, Web of Science, and CINAHL. Key words included “blood pressure” and “lymphedema” and (“breast cancer” or “breast neoplasm”). The quality of evidence was assessed using the GRADE Working Group guidelines.

Results: A total of 4 articles were included in this systematic review, all of which were prospective cohort studies. Three studies found no significantly increased risk of lymphedema with blood pressure measurements. One study measured lymphedema using 3 different techniques and found a significantly increased risk with one of the techniques but not the others.

Conclusion: This systematic review refutes the current guidelines that patients should avoid blood pressure monitoring in the affected arm. Further research that looks at how to define lymphedema and how to best diagnose it in the clinic will help with implementing earlier treatment.

Keywords: Blood pressure, lymphedema, breast cancer, and breast neoplasm

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