A guest blog post by Ryan Cliche, Executive Director, American Society of Breast Surgeons Foundation.
A recent publication of the interim analysis from a multisite randomized controlled trial led by Vanderbilt University School of Nursing demonstrated results consistent with recent findings that patients undergoing surveillance with bioimpedance spectrometry (BIS) had reductions in the rates of lymphedema progression requiring resource-intensive and costly complete decongestive physiotherapy (CDP) compared with monitoring with tape measure (10% absolute reduction and 67% relative reduction in the rates of CDP), supporting the need for subclinical detection and early intervention for patients with breast cancer-related lymphedema (BCRL).
In other words, the National Comprehensive Care Network (NCCN) Guidelines for Breast Cancer regarding early detection and diagnosis of lymphedema were not enough.
Early detection of lymphedema is critical for optimal outcomes. You know that; we know that. However, these NCCN guidelines needed to better reflect just how critical it is. The American Society of Breast Surgeons Foundation, Vanderbilt University School of Nursing, Lymphatic Education & Research Network, and Impedimed decided they needed to step in to help educate NCCN and advocate for patients struggling with lymphedema.
Through a campaign of letters to NCCN and patient advocacy, these organizations collaborated to achieve a sweet victory: NCCN updated its guidelines in February 2020.
“We are so grateful for this teamwork approach among The American Society of Breast Surgeons Foundation, Vanderbilt University School of Nursing, Lymphatic Education & Research Network, and Impedimed,” said Beth Boyd, RN, Chairman, American Society of Breast Surgeons Foundation. “This BCRL patient advocacy victory is certainly a step in the right direction; we hope that our efforts will encourage more early detection.”
The updated guidelines will better enable detection of subclinical BCRL. In turn, it would result in early intervention, which would reduce the need for CDP. The updated clinical practice guidelines now encourage healthcare providers to consider pre-treatment measurements for patients with lymphoedema risk factors. The NCCN guidelines are widely referenced by providers and decision-makers when implementing or updating care and coverage of oncology patient services.