SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Breast Cancer
This article is part of the Research TopicComprehensive Management and Risk Assessment of Breast Cancer-Related Lymphedema: A Multidisciplinary ApproachView all 3 articles
Pharmacotherapy agents in prevention and treatment of breast cancer-related lymphedema: A systematic scoping review
Provisionally accepted
Caroline Lommer1Lila Schroeder2
Caroline Amato2Caitlin Kotian3
Dionisia Quiroga4
Electra Diane Paskett3Mei Fu5
Ann McAlearney6Stephanie Collins3Tari A. King7
Sarah McLaughlin8
Sara P. Myers9*- 1The Ohio State University College of Medicine, Columbus, United States
- 2Columbus School For Girls, Columbus, United States
- 3The Ohio State University Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, United States
- 4The Ohio State University Wexner Medical Center, Columbus, United States
- 5University of Missouri-Kansas City, Kansas City, United States
- 6Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research,, Columbus, United States
- 7Emory University School of Medicine, Atlanta, United States
- 8Mayo Clinic in Florida, Jacksonville, United States
- 9The James Cancer Hospital and Solove Research Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, United States
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ABSTRACT: 337/350 BACKGROUND: Breast cancer-related lymphedema (BCRL) is a common and life-long adverse event affecting ~20% of breast cancer survivors. As existing non-pharmacologic management is burdensome, expensive, and variably effective, this systematic scoping review aims to identify pharmacologic and herbal agents for prevention and treatment for BCRL. METHODS: PubMED, Embase, Web of Science Core collection, and the Cumulative Index to Nursing and Allied Health Literature were searched for studies published in English between 1993 and 2025 that investigated the preventative or therapeutic effect of pharmacologic or herbal agents on BCRL among adult stage I-III breast cancer patients. Studies describing interventions with systemically absorbed anti-inflammatories, anti-thrombotics, anti-coagulants, and blood product components were included. Systematic reviews, protocols for ongoing clinical trials, preclinical and non-human studies, editorials, and studies not exclusive to BCRL were excluded. Three reviewers screened and extracted data between June and August 2025. The primary outcomes of interest were reduction in BCRL incidence or severity. RESULTS: Of the 217 articles screened, 37 were included in the final review. After full text review, 13 were excluded for repetitive data, non-English language, or irrelevant outcomes. The 24 studies included in the analysis investigated anti-diabetic, herbal, anti-inflammatory, anti-hypertensive, immunomodulatory, and microbiome modifying agents, and venoactive flavinoid derivates. Three studies explored the role of pharmacologic/herbal agents in BCRL prevention. While thiazolidinediones, anti-hypertensives, and non-steroidal anti-inflammatory drugs (NSAIDs) had no effect on BCRL incidence, glucagon-like peptide-1 receptor agonists (GLP-1 RA) were associated with BCRL prevention. In the 21 studies that assessed the effect of pharmacologic/herbal agents in BCRL treatment, NSAIDs/steroids, anti-hypertensives,
Keywords: Breast, Breast cancer related lymphedema (BCRL), Lymphedema, Pharmacotherapy, Upper Extremity
Received: 24 Nov 2025; Accepted: 05 Feb 2026.
Copyright: © 2026 Lommer, Schroeder, Amato, Kotian, Quiroga, Paskett, Fu, McAlearney, Collins, King, McLaughlin and Myers. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sara P. Myers
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