Breast cancer related lymphoedema: a review of contemporary preventive strategies

Secondary lymphoedema remains an incurable long-term complication of breast cancer treatment. Prevention is our best chance against this debilitating condition. Strategies for selective de-escalation of oncological therapies have continued to evolve over the last few decades to reduce the incidence of this feared complication. In this manuscript we first review the current strategies in de-escalation of axillary treatment. We then review the current evidence for immediate lymphatic reconstruction in those high-risk patients who cannot be spared from more aggressive axillary management.