When should I refer a patient with lymphoedema to a specialist for further management?

Refer a patient with lymphoedema to a specialist lymphoedema service for further assessment and management as soon as lymphoedema develops, particularly in patients with breast cancer or other underlying causes. This referral should enable detailed evaluation of the lymphoedema, consideration of conservative management options, and discussion of possible surgical interventions if appropriate.

Before initiating any lymphoedema management programme, assess for treatable underlying factors such as nodal disease or cellulitis, which may influence treatment decisions.

Additionally, provide patients with education about lymphoedema, including skin and nail care to prevent complications, recognition of serious complications like cellulitis or deep vein thrombosis, and information about support groups.

Early referral is important to optimise outcomes and prevent progression or complications of lymphoedema.