Prevention of Breast Cancer-Related Arm Lymphoedema (BCRAL)

Publication Date: February 1, 2024

Last Updated: February 29, 2024

Summary of Recommendations

When there are resource constraints, patients who present with a higher BMI (BMI ≥30 kg/m2) should be prioritised over patients with BMI <30 kg/m2 when selecting patients for prophylactic management of lymphoedema.
The timing of chemotherapy (neoadjuvant versus adjuvant) may impact the subsequent risks of lymphoedema but should not be a major determining factor on selecting patients for prophylactic management of lymphoedema until more studies are available.
The type of chemotherapy (taxane versus non-taxane) a patient receives may impact the subsequent risks of lymphoedema, but should not be a major determining factor on selecting patients for prophylactic management of lymphoedema until more studies are available.
When there are resource constraints, patients who had ≥15 axillary lymph nodes removed in axillary dissection should be prioritised over patients who had less lymph nodes removed when selecting patients for prophylactic management of lymphoedema.
When there are resource constraints, patients who received axillary radiation should be prioritised over patients who receive radiation to the breast/chest wall ± the supraclavicular fossa when selecting patients for prophylactic management of lymphoedema.