About 20% of patients with breast cancer are likely to develop breast cancer-related lymphedema (BCRL) following an axillary clearance, and BCRL can be refractory or irreversible to treatment. The aim of this pilot randomized controlled study was to evaluate the effectiveness of a 10-min holistic self-care program for patients with BCRL in Japan. The intervention group (n = 22) practiced the BCRL self-care program including 1) modified Japanese Radio Taiso (Rajio Taiso, national calisthenics in Japan), 2) gentle arm exercises combined with deep breathing, 3) central lymphatic drainage, and 4) skin care using a traditional lymphatic drainage technique daily for 6 months, while the control group (n = 21) received usual care from their hospitals. There was significant group*time interaction in the relative edema volume and relative volume change of the hand, with the intervention group having the better outcome. The intervention group showed significant improvement in transepidermal water loss as well as the mental health component summary score of the SF-8, most of BCRL-related symptoms, self-care time and score, frequencies of exercise, self-lymphatic drainage and skin care, and perceived adherence and effectiveness to self-care, although we were unable to exclude the possibility of the Hawthorne effect. Notably, even in the control group, the self-care was similarly increased, but the significant improvements were detected only in transepidermal water loss on the forearm and upper arm, pain and coldness. In conclusion, the patients who practiced the holistic BCRL self-care for 6 months have shown greater improvement.

The many women with breast cancer who underwent axillary lymph node dissection (ALND) suffer from the upper arm dysfunction. In this study, we investigated the effectiveness of a perioperative educational program for improving upper arm dysfunction in breast cancer patients following ALND. This study was a sub-analysis of a previous controlled trial with an educational program. The subjects of this analysis included 64 patients following ALND who completed measurements at 12 months. The perioperative educational program consisted of monitoring of arm dysfunction, exercises, massage, and lifestyle adjustments. The intervention group (37 patients) received this perioperative educational program over 12 months, while 27 patients in the control group received written information about shoulder exercise from on-site staff only before surgery. Primary outcomes were shoulder range of motion (ROM), arm girth, and grip strength. Secondary outcomes were evaluated with the Subjective Perception of Post-Operative Functional Impairment of the Arm (SPOFIA) scores, the Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the Medical Outcome Study 36-Item Short-Form Health Survey v2 (SF-36v2). The SF-36v2 measures health-related quality of life (QOL). Primary and secondary outcomes were compared between groups at 1 week (after drainage tube removal) and 12 months after surgery, using the Mann-Whitney U test. The horizontal extension was significantly improved only in the intervention group. Moreover, the SPOFIA score was significantly improved in the intervention group, and other scores of the secondary outcomes were similar between the two groups. The perioperative educational program may improve postoperative upper arm dysfunction and symptoms.

Purpose: To assess the e ectiveness of a daily 10-minute self-care program, which involves exercising and skin moisturizing with aromatherapy using a self-lymphatic drainage technique over 3 months for patients with breast cancer treatment-related lymphoedema (BCRL).Methods: Twenty-seven patients with unilateral BCRL participated in this study. e primary endpoint was based on arm volume, whereas the secondary endpoints were based on oedema volume, relative volume change, skin tissue resistance, BMI, self-reported BCRL-related symptoms, skin condition, and time, score, adherence, e ectiveness and burden in self-care. Measurements were taken at baseline, a er 1 and 3 months of the program.Results: Twenty-ve participating patients completed the program. e signi cant di erence between baseline and 3 months with Bonferroni multiple comparison procedure was shown in the volume of the upper arm and whole arm on the a ected side, whereas the una ected side showed no notable change. Skin tissue resistance signi cantly declined in the both forearms. BMI was also reduced signi cantly. ere was a signi cant decrease in severity of arm discomfort regarding BCRL-related symptoms. Self-reported self-care time and self-care score, as well as patients perception regarding self-care adherence, signi cantly increased.Conclusion: Our 3-month self-care program may signi cantly lessen the severity of unilateral BCRL.1 10 BCRL 3