Evaluation of the results of three different methods of postmastectomy lymphedema treatment

Zanolla, R.; Monzeglio, C; Balzarini, A.; Martino, G

doi:10.1002/jso.2930260317

Cited by 57 publications

(24 citation statements)

References 4 publications

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“…The results of this investigation support the observation, reported in previous studies, [23][24][25][26][27] that pneumatic compression pumps can be used safely and effectively for the treatment of patients with breast carcinoma-associated lymphedema. Conversely, we were unable to validate published claims that IPC has a deleterious effect on patients who receive prior treatment for lymphedema.…”

Section: Discussionsupporting

confidence: 90%

“…The incorporation of IPC into a multidisciplinary, therapeutic approach long has been advocated empirically by some physiotherapeutic schools. 21,22 Numerous early studies purported to demonstrate the efficacy of pumps as a sole therapeutic intervention for patients with lymphedema; [23][24][25][26][27] nevertheless, individual reports of complications and lack of efficacy 28 -30 have tended to dampen enthusiasm for the use of IPC. It was to address these unresolved questions that the current study was undertaken.…”

Section: Discussionmentioning

confidence: 99%

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Decongestive lymphatic therapy for patients with breast carcinoma‐associated lymphedema

Szuba

Achalu

Rockson

2002

Cancer

185

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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

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Decongestive lymphatic therapy for patients with breast carcinoma‐associated lymphedema

Szuba

Achalu

Rockson

2002

Cancer

185

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“…In particular, it must be noted that a change in excess limb volume appeared to have no bearing on changes in psychological and social scoring on selfreport quantitative measure scores. 38,43,46,47,63 SLE increases psychological and social sequelae and this is in addition to the fear of cancer recurrence and metastasis. Women face multiple sequelae, which equate to exponential risk for distress and other psychological and social sequelae and the nonspecific instruments may not describe, adequately interpret, or add meaningful knowledge to research findings.…”

Section: Clinical Implications and Recommendationsmentioning

confidence: 99%

Psychologic and social sequelae of secondary lymphedema

McWayne

Heiney

2005

Cancer

198

114

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Objective Human immunodeficiency virus (HIV) infection of the central nervous system (CNS) is frequently associated with intrathecal immunoglobulin synthesis and cerebrospinal fluid (CSF) pleocytosis, but little is known about the B‐cell response in the CSF of these patients. In this study, we investigated the relation between virus load and the frequency and phenotype of B cells in the CSF of HIV‐infected patients. Methods The distribution of T cells, B cells, short‐lived plasmablasts, and long‐lived plasma cells was analyzed by flow cytometry in CSF and peripheral blood of 33 patients with HIV infection compared with 12 patients with noninfectious CNS diseases. HIV RNA copy number in CSF and serum was quantified by kinetic polymerase chain reaction. Results B‐cell and plasmablast levels were increased in the CSF of HIV‐infected patients compared with patients with noninfectious CNS diseases. Whereas CSF B cells were found at similar frequency during early and late stages of HIV infection, plasmablasts were more prevalent in the CSF during early infection. Plasmablasts in the CSF correlated with intrathecal IgG synthesis and even stronger with HIV RNA copy numbers in CSF, in particular, in untreated, early HIV‐infected individuals. Initiation of antiviral treatment in therapy‐naive patients strongly decreased HIV copy numbers and plasmablasts in CSF. Interpretation Our findings demonstrate that HIV infection of the CNS triggers an early profound B‐cell response, with plasmablasts serving as the main virus‐related B‐cell subset in the CSF. Ann Neurol 2007

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“…2 Breast cancer survivors with lymphedema (BCS-LE) experience psychosocial and physical difficulties and a poorer quality of life than those without lymphedema. [8][9][10][11][12][13] They also have a unique cluster of symptoms associated with lymphedema-alteration in limb sensation, loss of confidence in body, decreased physical activity, fatigue, and psychological distress. 14 This cluster is present in individuals who have undergone professional limb volume reduction treatment and are purportedly self-managing the condition.…”

Section: Introductionmentioning

confidence: 99%

“…16 Poor adherence to prescribed self-care activities may partially explain the psychosocial and physical difficulties experienced by these individuals. [8][9][10][11][12][13] Lifelong lymphedema self-care is required to reduce exacerbations of swelling and infections, maintain arm function, and slow disease progression. 17 Patients determine satisfaction with the outcomes associated with self-regulation behaviors (i.e., self-care) based on available information.…”

Section: Introductionmentioning

confidence: 99%

Bioelectrical Impedance Self-Measurement Protocol Development and Daily Variation Between Healthy Volunteers and Breast Cancer Survivors with Lymphedema

Ridner

Bonner

Doersam

et al. 2014

Lymphatic Research and Biology

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Background: A significant percentage of breast cancer survivors are at risk for lymphedema for which lifelong self-care is required. Previous studies suggest that less than 50% of breast cancer survivors with lymphedema (BCS-LE) perform prescribed self-care tasks and that even wearing a compression sleeve, the most commonly reported self-care activity, is done irregularly. Reasons for poor self-care adherence include perceived lack of results from self-care (no available arm volume data) and perceived inability to manage the condition. Methods and Results: A two-part pilot study was conducted to: 1) develop and determine the feasibility of a selfmeasurement protocol using a single frequency bioelectrical impedance device; and 2) examine daily variation in extracellular volume in healthy and lymphedematous limbs. Healthy and BCS-LE volunteers were recruited to refine and test a self-measurement protocol. Volunteers were trained in the use of the device and measured for 5 consecutive days in a laboratory setting. They were then given the device to use at home for an additional 5 consecutive days of self-measurement. All volunteers completed each scheduled home measurement. Daily variability in both groups was noted. Conclusions: Home self-measurement using bioelectrical impedance is feasible, acceptable, and captures change. This has implications for both self-care support and for the possibility of incorporating self-measurement using bioelectrical impedance in future clinical trials examining effectiveness of lymphedema treatment.

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Evaluation of the results of three different methods of postmastectomy lymphedema treatment

Cited by 57 publications

References 4 publications

Decongestive lymphatic therapy for patients with breast carcinoma‐associated lymphedema

Decongestive lymphatic therapy for patients with breast carcinoma‐associated lymphedema

Psychologic and social sequelae of secondary lymphedema

Bioelectrical Impedance Self-Measurement Protocol Development and Daily Variation Between Healthy Volunteers and Breast Cancer Survivors with Lymphedema

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