Decongestive lymphatic therapy for patients with breast carcinoma‐associated lymphedema

Abstract

BACKGROUNDDisruption of the lymphatic circulation through breast carcinoma‐associated axillary lymph node dissection, with or without radiation therapy, reportedly is the most common cause of lymphedema in developed countries. There is no cure for breast carcinoma‐associated lymphedema. Although intermittent pneumatic compression (IPC) has been acknowledged as a potential component of the multidisciplinary therapeutic strategy in the treatment of patients with breast carcinoma‐associated lymphedema, prospective study of its adjunctive safety and efficacy is required.METHODSIPC was assessed as a component of the initial therapeutic regimen for newly treated patients with breast carcinoma‐associated lymphedema. Twenty‐three patients who had not previously been treated for lymphedema were randomized to receive either decongestive lymphatic therapy (DLT) alone or DLT with daily adjunctive IPC. Patients with stable, treated, breast carcinoma‐associated lymphedema also were assessed in the maintenance phase of therapy. Twenty‐seven patients were randomized either to DLT alone or to DLT coupled with daily IPC. In both studies, objective assessment included serial measurement of volume by water displacement, tissue tonometry to assess elasticity of the skin, and goniometry to measure joint mobility.RESULTSDuring initial treatment, the addition of IPC to standard DLT yielded an additional mean volume reduction (45.3% vs. 26%; P < 0.05). During maintenance DLT alone, there was a mean increase in volume (32.7 ± 115.2 mL); with DLT and IPC, there was a mean volume reduction (89.5 ± 195.5 mL; P < 0.05). In both studies, IPC was tolerated well without detectable adverse effects on skin elasticity or joint range of motion.CONCLUSIONSWhen IPC is used adjunctively with other, established elements of DLT, it provides an enhancement of the therapeutic response. IPC is well tolerated and remarkably free of complications. Cancer 2002;95:2260–7. © 2002 American Cancer Society.DOI 10.1002/cncr.10976

Physiotherapy treatments for breast cancer-related lymphedema: a literature review

“…PC has been used in lymphedema reduction treatment and it was concluded that no difference in reduction occurred in comparison with a control group (19) . Some studies associated components of CDT with pneumatic compression (20)(21) .…”

Bilateral Upper Extremity Edema in the Psoriatic Arthritis Case

“…In general, the treatment of lymphedema focuses on decreasing the swelling in the extremity, controlling symptoms, and reducing complications (17). Because lymphedema associated with PsA and rheumatoid arthritis can be related to the inflammation process, it is important to closely follow-up these patients and to take the disease under control in patients developing lymphedema (8).…”

Recent Advances in Medical Treatment for Lymphedema

“…(2) Intermittent pneumatic compression [17][18][19] In this procedure, a cuff is worn on the affected limb, and air is intermittently infused from the periphery of the affected limb toward the center for compression. Its therapeutic effects remain controversial.…”