There are no official BCRL guidelines or protocols in the South African healthcare system.
Against this backdrop BCRL referral and management guidelines and other recommendations are proposed for South Africa (Tables 1 and 2).
All newly diagnosed patients and those with BCRL symptoms should be referred appropriately.
Referral pathway guideline within and from the various levels of care Level of care Guideline Level 3/level 2: All newly diagnosed tertiary/secondary patients to hospital (public hospital-based health) lymphoedema service for BCRL information and pre-treatment measurements of limbs Patients with BCRL symptoms to lymphoedema service for assessment and treatment plan Level 1: primary Patients with BCRL level clinics, symptoms to community healthcare lymphoedema trained centres clinical staff for assessment and management and to home/based carer/ rehabilitation careworker to provide support within the community BCRL = breast cancer-related lymphoedema.
Managing BCRL is very intense and could become cumbersome for the therapist, caregiver and affected person.
National Department of Health (NDoH) to facilitate development of a breast health-cancer policy that includes BCRL management guidelines.
NDoH to facilitate integration of BCRL management guidelines into the chronic diseases directorate policy as lymphoedema is a chronic condition.
BCRL epidemiology and management to be integrated into training curricula of healthcare professionals and rehabilitation careworkers (RCWs)/home-based carers (HBCs).
Research to be conducted to inform the development of BCRL treatment protocols in South Africa.