Medical Procedures Safety for Breast Cancer Survivors Considering Lymphedema: A Systematic Review

Introduction: Lymphedema is one of the most disturbing complications of breast cancer treatment and some routine medical procedures such as blood pressure (BP) monitoring or injections have been reported to be the major risk factors for lymphedema. This systematic review aimed to shed light on the safety of some medical procedures among breast cancer survivors with and without lymphedema. Methods: An electronic systematic search in Pubmed and Scopus was undertaken from 1 January 1992 to 12 May 2020 and all relevant studies were summarized in a table based on the PRISMA guideline. Results: Twentythree articles were included from which 11 and 8 articles were prospective and retrospective original studies, respectively. The remaining 4 articles were case reports. BP measurement, injections, blood draw, and hand surgeries were the medical procedures of interest. Most of the included studies have reported that these medical procedures did not result in lymphedema initiation or worsening in breast cancer survivors; however, case reports of the harmful effects of these procedures were also included in this systematic search. Conclusions: Although recent welldesigned prospective studies did not show any significant side effects from medical procedures in breast cancer survivors, concerns exist for both healthcare staff and patients. Additionally, it seems that there are specific aspects that have not been investigated properly in previous studies and should be considered in future studies.