Editorial: Comprehensive management and risk assessment of breast cancer-related lymphedema: a multidisciplinary approach

Lymphedema is a chronic, progressive condition caused by impaired lymphatic drainage, leading to protein-rich fluid accumulation in tissue. 1 Secondary lymphedema is the most common form in the United States, and as breast cancer survival rates have improved, the prevalence of breast cancer-related lymphedema (BCRL) has grown substantially. 2 Affected patients experience upper limb swelling, pain, restricted movement, recurrent infections, and in severe cases, elephantiasis, alongside considerable psychosocial consequences such as anxiety, depression, and diminished body image -all of which significantly impair quality of life. 2,3 Contemporary axillary management strategies have contributed to a reduction in the incidence of BCRL. Sentinel lymph node biopsy (SLNB), which minimizes disruption of the axillary lymphatic network compared with axillary lymph node dissection, is associated with significantly lower rates of postoperative lymphedema while maintaining accurate oncologic staging. 2,3 Furthermore, in carefully selected patients with early-stage, clinically node-negative breast cancer, emerging evidence supports the omission of sentinel node procedures altogether, thereby further reducing surgical trauma to the lymphatic system and potentially lowering the risk of BCRL without compromising oncologic outcomes. 2,3 Treatment options span conservative approaches like compression therapy and physiotherapy to surgical interventions including lymphovenous anastomosis (LVA), vascularized lymph node transfer (VLNT), and liposuction for advanced disease. Collectively, these contributions delineate a research agenda that is simultaneously broad and urgent. From molecular biomarker identification and machine learning-based risk stratification, to the optimization of physical therapy duration and the exploration of novel pharmacological targets, this Research Topic advances the field across multiple dimensions. The consistent call for prospective, standardized, and longer-term studies reflects a shared recognition that the current evidence base, though growing, remains insufficient to fully guide clinical practice.It is our hope that this collection will stimulate further interdisciplinary collaboration, inspire rigorous trial design, and ultimately translate into meaningfully improved outcomes for the millions of breast cancer survivors living with lymphedema worldwide.