Therapy modalities to reduce lymphoedema in female breast cancer patients: a systematic review and meta-analysis

Abstract

The aim of the present study was to evaluate the effects of compression bandages, sleeves, intermittent pneumatic compression (IPC) and active exercise on the reduction of breast cancer-related lymphoedema (BCRL). A systematic literature search up to the year January 2016 was performed in CINAHL, Cochrane Register of Controlled Trials, Embase, International Clinical Trials Registry Platform (WHO), PEDro and PubMed. Inclusion criteria were (1) RCTs, (2) reported adequate statistics for meta-analysis, (3) English or German language. Exclusion criteria were (1) effects of drugs, hormonal, radiation and surgical procedures, (2) studies with children, (3) non-breast cancers, lower extremity oedema, (4) impact on fatigue only, diets or sexually transmitted diseases, (5) cost-analysis only and (6) non-carcinogenic syndromes or (7) prevention of breast cancer. After scoring the methodological quality of the selected studies, data concerning volume reduction of the oedema swelling were extracted. Thirty-two studies were included in this systematic review. Nine studies were selected for the RCT-based studies and 19 studies were included in the pre-post studies-based random-effects meta-analyses. All conclusions should be taken with precautions because of the insufficient quality of the selected papers. Exercise seems beneficial in reducing oedema volume in BCRL. IPC seems beneficial in helping to reduce the oedema volume in the acute phase of treatment. Compression sleeves do not aid in the volume reduction in the acute phase; however, they do prevent additional swelling.

‘Oncokompas’, a web-based self-management application to support patient activation and optimal supportive care: a feasibility study among breast cancer survivors

“…The usefulness of Oncokompas in general 11 (19) Oncokompas was offered too late in the treatment process 14 (24) The advice provided by Oncokompas was useful 8 (14) Participants are not able to find the information they are looking for 12 (20) The questions and outcomes in Oncokompas are clear 7 (12) The well-being score is not congruent with participants' own perception 9 (15) Oncokompas provides a reflection and acknowledgement of one's personal situation 5 (8) Topics are not applicable to the participants' personal situation 9 (15) Oncokompas is easy to use 5 (8) Advice in Oncokompas is too generic or obvious 8 (14) Participants missed instructions how to make use of Oncokompas 7 (12) Participants missed the possibility of open questioning 7 (12) The questions in Oncokompas evoke emotions 6 (10) one's personal situation' another survivor mentioned: 'I recognized things and that was pleasant. '…”

“…To address these symptoms, survivors need to have access to supportive care services such as psychosocial care by a health care professional or self-help interventions (e.g., targeting a healthy lifestyle) [6,7]. Although supportive care has been proven effective for a range of cancer-related symptoms [8][9][10][11], relatively few survivors benefit from it [12] and as a result, many survivors have unmet care needs [13,14]. Additionally, reduced followup visits, resulting from an increasing evidence for the lack of effect of routine follow-up on early detection of cancer recurrence [15], might lead to a further increase in unmet needs in cancer survivors.…”

Physical Activity, Exercise and Breast Cancer - What Is the Evidence for Rehabilitation, Aftercare, and Survival A Review

“…For example, pain and loss of sensitivity can be improved by strength training [39]. Water and home-based training could improve functional limitations in the affected arm as well as quality of life [40].…”

Oedema of advanced disease – aetiology, diagnosis, and palliative care management

“…W praktyce leczenia obrzęku chłonnego dobrze ugruntowaną pozycję ma połączenie kompresji z MLD, staranną pielęgnacją skóry oraz odpowiednio dobranymi ćwiczeniami aerobowymi i oddechowymi w kompleksową fizjoterapię przeciwobrzękową (complex decongestive therapy -CDT, lub combined physical therapy). W jej pierwszym etapie -intensywnym (kilka dni do kilku tygodni) -w kompresji wykorzystuje się wielowarstwowe bandażowanie, a czasem dodatkowo kilkudziesięciominutową przerywaną kompresję pneumatyczną z użyciem cyklicznie napełnianych powietrzem mankietów przez automatycznie sterowane przenośne pompy [42]. W drugim, przewlekłym etapie CDT, pozwalającym utrzymać osiągnięte początkowo efekty, bandażowanie zastępuje się zwykle noszeniem dopasowanych produktów uciskowych.…”