Combined Complete Decongestive Therapy Reduces Volume and Improves Quality of Life and Functional Status in Patients With Breast Cancer-Related Lymphedema

Abstract

Background: The aim of this study was to evaluate the effects of complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL), in regard to volume reduction, functional status and quality of life (QoL).Methods: Fifty patients with unilateral BCRL were included. The demographic variables focusing on lymphedema were recorded. All patients received combined phase 1 CDT including skin care, manual lymphatic drainage, multilayer bandaging and supervised exercises, ve times a week for three weeks, as a total of 15 sessions. Patients were assessed by limb volumes and excess volumes according to geometric approximation derived from serial circumference-measurements of the limb, prior and at the end of third week. The functional disability was evaluated by quick disability of arm, shoulder and hand questionnaire (DASH). Quality of life was assessed by the European Organization forResearch and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and its breast cancer module (EORTC-QLQ-BR23 ).Results: Fifty females with mean age of 53.22±11.2 years were included. The median duration of lymphedema was 12 months. There were 22 patients in stage1, 26 in stage2 and 2 patients in stage3. The mean baseline limb and excess volumes were signi cantly decreased at the end of therapies (3262±753cm³ vs 2943±646.6cm³ and 31.36±16.5% vs 19.12±10.4%, p=0.000,respectively). The DASH and EORTC-QLQ-C30 and BR23 scores were also decreased signi cantly (p<0.05). The improvements in volumes were related negatively with the duration of lymphedema,and the stage of lymphedema. Conclusion:In conclusion phase 1CDT in a combined manner performed daily for 3 weeks, greatly reduces the volumes as well as improves the disability and QoL, especially when performed earlier.

Effect of progressive resistance exercise using Thera-band on edema volume, upper limb function, and quality of life in patients with breast cancer-related lymphedema

“…However, there was no significant difference in symptom scales other than insomnia. This is because BCRL is associated with radiotherapy and cancer treatment ( Borman et al, 2021 ). In contrast, no significant difference was noted in the SREG for any items ( Table 6 ).…”

“…Do et al (2015) reported that the QoL of patients with BCRL improved according to the EORTC QLQ C30 evaluation after performing a combination of CDPT and resistance exercises, showing their correlation with lymphedema reduction and improvement of functional disability. Borman et al (2021) reported that, according to the EORTC QLQ C30 evaluation, QoL had improved in patients with BCRL who had reduced lymphedema through treatment intervention, and a high QoL improvement can be expected the sooner the intervention. These results support the idea that Thera-band exercise in this study contributed to the reduction in edema volume as well as the improvement of grip strength, upper limb function, and QoL.…”

What do we know about treating breast-cancer-related lymphedema? Review of the current knowledge about therapeutic options

“…Keskin et al showed that the benefits were greater if the CDT was applied in the early lymphedema stage (stage I) [45]. Findings were confirmed by Borman et al, who reported that improvements in volume were related negatively with the stage of BCRL, and additionally, with the duration of the disease [47]. Therapeutic effect seems to be increased if the duration of lymphedema is less than 1 year [48].…”

Application of complete decongestive therapy after lymphaticovenular anastomosis of the lower limb combined with liposuction-A retrospective study research

“…19 MLD includes four basic techniques (stationary circle, rotary, pump, and scoop techniques), starting from the adjacent segments of the affected limb; the direction of action is from the distal end to the proximal end, following the physiological lymphatic reflux direction. 20 In stage 1, compression bandaging is pressure bandaging through tubular bandages, finger/toe bandages, padding bandages, and low-pressure bandages. In stage 2, elastic mesh sleeves that cover from the root of the thigh to the ankle are worn to antagonize muscle contraction, which helps to reduce interstitial fluid production and lymphatic load.…”