Breast Cancer Guideline Addresses Link Between Exercise and Lymphoedema

The National Institute for Health and Care Excellence (NICE) has published draft recommendations to provide clarity on the link between exercise and breast cancer-related lymphoedema. This is a painful and incurable condition that causes chronic swelling of the arm or nearby areas. It is likely that each year in the UK, nearly 10,000 people with breast cancer will go on to develop lymphoedema in the arm following treatment[1]

NICE is currently updating its guidance on the diagnosis and treatment for people with advanced breast cancer following new evidence on the safety and benefit of exercise for breast cancer-related lymphoedema. NICE has developed two new draft recommendations, which have been published for consultation, to directly address this issue.

Professor Mark Baker, Director of the NICE Centre for Clinical Practice, said: “Lymphoedema is a long-term condition which occurs when the body’s lymphatic system becomes damaged and is unable to drain fluid in the normal way. For breast cancer patients, lymphoedema may occur as a result of treatment – such as surgery or radiotherapy – or cancer cells blocking the lymph system. This results in swelling that is often painful and makes joints stiff and difficult to move.

“Some people may be cautious of taking up exercise as they may think it could make their lymphoedema worse or bring it about in the first place. Our proposed new recommendations should clear up any confusion relating to the role that exercise can play for people with or at risk of this condition. With no cure available for lymphoedema, it is important that we provide clarity on effective ways to manage and control it where there is evidence to do so.”

The specific draft recommendations say that doctors and nurses should:

  • Discuss with people who have or who are at risk of breast cancer related lymphoedema that exercise may improve their quality of life
  • Discuss with people who have or who are at risk of breast cancer related lymphoedema that current evidence indicates that exercise does not prevent, cause or worsen lymphoedema

These new recommendations have been developed as part of NICE’s new clinical guideline update process. This method aims to produce small and specific updates to NICE guidance more quickly than the standard clinical guideline process, if new evidence arises in very precise areas of healthcare.


News released by NICE.

Notes to Editors

About the guidance

1. The draft recommendations, which will update the NICE guideline on advanced breast cancer, will be available from Wednesday 12 March 2014.

2. Once published, the proposed recommendations for people with breast cancer-related lymphedema will update NICE’s current advanced breast cancer guideline. However, all other recommendations will remain the same.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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[1] About 50,000 women and 400 men are diagnosed with breast cancer each year in the UK. According to Cancer Research UK, 1 in 5 people who have been treated for breast cancer will go on to develop lymphedema in the arm.