Effectiveness of six-step complex decongestive therapy for treating upper limb lymphedema after breast cancer surgery

Abstract

BACKGROUND Complex decongestive therapy (CDT) is currently recommended as the standard treatment for lymphedema. CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery, and is considered non-invasive, painless and without side effects. AIM To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention. METHODS The study included 100 patients with upper extremity lymphedema after breast cancer surgery. The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy. The study population was further divided into the experimental group and control group with 50 cases in each group. The control group was given conventional CDT (four-step method), which included skin care, freehand lymphatic drainage, foam granule pressurized bandage, and functional exercise. In the experimental group, a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT. Patients in both groups were given one course of treatment daily (20 times), and the changes in body moisture and subjective symptoms were measured before and after treatment, preoperatively and 20 times after treatment. RESULTS No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment, suggesting comparability of the baseline data. After treatment, the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group, and the extracellular moisture ratio was significantly lower than that in the control group. A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group. After 20 treatments, according to subjective evaluations, the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group. CONCLUSION The six-step CDT method can effectively reduce lymphedema, promote lymphatic circulation, and alleviate the subjective symptoms of patients, and thereby improve the quality of life and treatment compliance among patients.

Comparison efficacy and safety of acupuncture and moxibustion therapies in breast cancer-related lymphedema: A systematic review and network meta-analysis

“…Pairwise meta-analysis suggested that BLC was superior to usual measures in all outcomes except VAS scores of swelling. This is inconsistent with previous study [58]. Perhaps due to the limited use of BLC treatment for BCRL in clinical practice, and insufficient sample size to support this [59].…”

Breast reconstruction and breast cancer-related lymphedema: insights and perspectives

“…In our systematic literature search, 23 studies, including a total of 85,584 patients, were published since the review by Siotos et al on BCRL and breast reconstruction [124] . In various studies, the incidence of lymphedema was found to be lower in cases with breast reconstruction compared to mastectomy alone [125][126][127][128][129][130][131][132][133][134] , while other studies did not specify the incidence of lymphedema for breast reconstruction [31,122,[135][136][137][138][139] , type of reconstruction [128,129,140] , or BCRL incidence at all [31] . Figure 1 presents an overview of the incidence reported for BCRL in the different studies, where possible, by reconstruction type.…”

“…Figure 1 presents an overview of the incidence reported for BCRL in the different studies, where possible, by reconstruction type. Further aspects emerged from the studies: Two recent large cohort studies published only as abstracts have found that delayed breast reconstruction (DBR) is significantly associated with reduced BCRL within ten years [127,131] . Both cohorts were extracted from the same 85,776,922 de-identified patient records.…”

“…The study was one of the few with baseline measurements of lymphedema, as only six out of 23 studies reported baseline measurements [70,122,134,140,142] . All six studies were prospective cohort studies with smaller cohort numbers compared to the three largest retrospective cohorts that included 24,136 [127] , 60,157 [131] , and 5,497 [126] patients, respectively. The largest of the prospective studies was performed by a research group from Massachusetts General Hospital and included 327 patients with a total of 578 reconstructed breasts [140] .…”

“…The other study included 72 patients but did not describe how or when they measured lymphedema [141] -only that the diagnosis was based on physical examination [141] . Unfortunately, this lack of description of measurement methods or diagnostic criteria was observed for some of the studies [131,138] . Diagnostic methods used in other studies were circumference [126,136,143] , bioimpedance spectroscopy (BIS) [70,134,142] , and perometry [129,140] .…”