Effects of Early Preventive Interventions on Breast Cancer-Related Lymphedema: A Meta-Analysis and Systematic Review

Yuejin Wu; Zijun Zhou; Jiong Li; Xinxin Wang; Zihan Qin; Yichen Li; Pengyue Ma; Xin Peng

doi:10.1097/NCC.0000000000001557

Effects of Early Preventive Interventions on Breast Cancer-Related Lymphedema: A Meta-Analysis and Systematic Review

Cancer Nurs. 2026 Mar 10. doi: 10.1097/NCC.0000000000001557. Online ahead of print.

Authors

Yuejin Wu¹, Zijun Zhou², Jiong Li¹, Xinxin Wang¹, Zihan Qin¹, Yichen Li¹, Pengyue Ma¹, Xin Peng¹

Affiliations

¹ School of Nursing, Jilin University, Changchun, China (Wu, J. Li, Wang, Qin, Y. Li, Ma, and Peng).
² Department of Breast Surgery, Jilin Cancer Hospital, Changchun, China (Zhou).

PMID: 41817405
DOI: 10.1097/NCC.0000000000001557

Abstract

Background: Breast cancer-related lymphedema (BCRL) is among the most common complications associated with breast cancer treatment, yet the effectiveness of early preventive interventions remains unclear.

Objective: To evaluate the effectiveness of early preventive interventions for preventing BCRL and explore the optimal intervention components and timing for initiation.

Interventions/methods: Six English-language databases were systematically searched from inception to March 5, 2025. The primary outcome was the incidence of BCRL. The secondary outcomes were quality of life, upper limb function, and lymphedema-related symptoms. Data were synthesized using RevMan 5.4.

Results: A total of 1116 studies were identified, and 13 studies were included in the final analysis. Early preventive interventions significantly reduced the incidence of BCRL (relative risk = 0.48; 95% confidence interval: 0.29-0.80, P =.005) and improved upper limb function (standardized mean difference = -1.65, 95% confidence interval: -2.79 to -0.51, P =.004). No significant improvement was observed in quality of life, and the effects on lymphedema-related symptoms remain inconclusive. Subgroup analyses did not show significant differences based on intervention component.

Conclusion: Early preventive interventions not only effectively reduce the incidence of BCRL but also improve upper limb function. However, the optimal combination of interventions and the optimal timing for their initiation remain unclear. High-quality randomized controlled trials are needed in the future to further validate these benefits and establish standardized, evidence-based guidelines for early prevention.

Implications for oncology nursing practice: Prevention strategies for BCRL should focus on optimizing intervention content, primarily including structured health education and personalized exercise prescriptions based on functional status and treatment history.

Keywords: Breast cancer; Lymphedema; Meta-analysis; Quality of life; Self-management.