{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:36:40Z","timestamp":1791005800748,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T00:00:00Z","timestamp":1670284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Scientific Fund of the Medical Center Leeuwarden"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change \u22655%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.<\/jats:p>","DOI":"10.3390\/cancers14236016","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T04:00:37Z","timestamp":1670385637000},"page":"6016","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Early Referral for Breast-Cancer-Related Lymphedema: Do We Follow the Evidence? A Two-Year Prospective Multicenter Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Ad A.","family":"Hendrickx","sequence":"first","affiliation":[{"name":"Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands"},{"name":"Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands"},{"name":"Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia W.","family":"K\u00fcthe","sequence":"additional","affiliation":[{"name":"Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands"},{"name":"Department of Plastic, Reconstructive and Hand Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cees P.","family":"van der Schans","sequence":"additional","affiliation":[{"name":"Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands"},{"name":"Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands"},{"name":"Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim P.","family":"Krijnen","sequence":"additional","affiliation":[{"name":"Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal M.","family":"Mou\u00ebs-Vink","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Damstra","sequence":"additional","affiliation":[{"name":"Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S1470-2045(13)70076-7","article-title":"Incidence of unilateral arm lymphoedema after breast cancer: A systematic review and meta-analysis","volume":"14","author":"DiSipio","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3536","DOI":"10.1200\/JCO.2007.14.4899","article-title":"Lymphedema After Breast Cancer: Incidence, Risk Factors, and Effect on Upper Body Function","volume":"26","author":"Hayes","year":"2008","journal-title":"J. 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Implement Rep."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/6016\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:35:17Z","timestamp":1760146517000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/6016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,6]]},"references-count":40,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["cancers14236016"],"URL":"https:\/\/doi.org\/10.3390\/cancers14236016","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,6]]}}}