A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema

Abstract

This paper describes a randomized controlled crossover study examining the effects of manual lymphatic drainage (MLD) in 31 women with breast cancer‐related lymphoedema. MLD is a type of massage used in combination with skin care, support/compression therapy and exercise in the management of lymphoedema. A modified version of MLD, referred to as simple lymphatic drainage (SLD), is commonly taught as a self‐help measure. There has been limited research into the efficacy of MLD and SLD. The study reported here explores the effects of MLD and SLD on a range of outcome measures. The findings demonstrate that MLD significantly reduces excess limb volume (difference, d=71, 95% CI=16–126, P=0.013) and reduced dermal thickness in the upper arm (d=0.15, 95% CI=0.12–0.29, P =0.03). Quality of life, in terms of emotional function (d=7.2, 95% CI=2.3–12.1, P=0.006), dyspnoea (d=−4.6, 95% CI=−9.1 to −0.15, P=0.04) and sleep disturbance (d =−9.2, 95% CI=−17.4 to −1.0, P=0.03), and a number of altered sensations, such as pain and heaviness, were also significantly improved by MLD. The study provides evidence to support the use of MLD in women with breast cancer‐related lymphoedema. The limitations of the study are outlined and future areas for study are highlighted.

Physiotherapeutic stimulation: Early prevention of lymphedema following axillary lymph node dissection for breast cancer treatment

“…Preventive measures, such as lymphatic self-massage, hydration, kinesiotherapy, manual lymphatic drainage and the use of elastic compression armbands, have been gaining increasing attention (12,18). None is more important than the others, but used together they may be effective in controlling and preventing lymphedema.…”

“…None is more important than the others, but used together they may be effective in controlling and preventing lymphedema. The only requirement is that the patient must be taught how to carry out the procedures on a daily basis (18)(19)(20)(21). Self-massage, also known as simple manual lymphatic drainage, is a version of manual lymphatic drainage in which the patient learns the procedure and is able Physiotherapeutic stimulation: Early prevention of lymphedema following axillary lymph node dissection for breast cancer treatment to perform it alone, at home.…”

Lymphedema: From diagnosis to treatment

“…CDT is a good option in decreasing LE volume and includes manual lymph drainage, compression therapy, physical exercise, skin care as self-management, followed by wearing compression garments (23,24). Although it is safe and effective in most patients, it is expensive, time-consuming and needs certified therapists.…”

“…MLD is a hands-on technique and differs from standard massage by orienting the lymphedematous fluid to proper functioning lymphatics (24).…”

Bilateral Changes in Deep Tissue Environment After Manual Lymphatic Drainage in Patients with Breast Cancer Treatment-Related Lymphedema

“…Though volumetric measurements serve as the most commonly used clinical mechanism for quantifying treatment impact, there is question whether this indirect volumetric measurement is sensitive enough to discern the impact of the CDT components. Multiple studies have been designed in attempts to investigate volumetric changes as a response to MLD over time and some find MLD successful at reducing limb volume 28,29 while others have found no effect. 30,31 BIS has been used to investigate its potential to identify early signs of lymphedema before overt edema is detected and before the early symptoms of arm heaviness and generalized ache.…”