Skip to main content

Advertisement

Log in

Lymphedema Therapy Reduces the Volume of Edema and Pain in Patients with Breast Cancer

  • Breast
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Despite recent advances in breast-conserving surgery, upper-extremity lymphedema remains a problem for patients after the treatment of breast cancer. This study examines the results of a protocol of therapy for lymphedema in breast cancer patients.

Methods

A total of 135 patients with lymphedema after breast cancer treatment were provided a protocol of complete decongestive therapy (CDT). This involved manual lymphatic drainage, compression garments, skin care, and range-of-motion exercises. Therapy was divided into an induction phase involving twice-weekly therapy for 8 weeks and maintenance therapy individualized to patient needs. Absolute volume and percentage of volume of lymphedema was compared before and after treatment. Also assessed was the degree of chronic pain and the need for pain medication.

Results

Mean initial lymphedema volume was 709 mL, and the percentage of lymphedema was 31%. The induction phase of CDT reduced this to 473 mL and 18%, respectively. Before therapy, 76 patients had chronic pain and 41 required oral pain medication. CDT reduced this to 20 and 11, respectively. The degree of pain was also assessed on a numerical scale from 0 to 10. Those patients with chronic pain initially rated their pain at an average of 6.9. After treatment, this was reduced to 1.1.

Conclusions

Lymphedema continues to be a problem for patients with breast cancer. A program of lymphedema therapy can reduce the volume of edema and reduce pain in this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

FIG. 1.
FIG. 2.
FIG. 3.
FIG. 4.

Similar content being viewed by others

REFERENCES

  1. Petrek JA, Heelan MC. Incidence of breast carcinoma-related lymphedema. Cancer 1998; 83(12 Suppl American):2776–81

    Article  PubMed  CAS  Google Scholar 

  2. Kissin MW, Querce della Rovere G, Easton D, Westbury D. Risk of lymphoedema following the treatment of breast cancer. Br J Surg 1986; 73:580–4

    Article  PubMed  CAS  Google Scholar 

  3. Meric F, Buchholz TA, Mirza NQ, et al. Long term complications associated with breast-conservation surgery and radiotherapy. Ann Surg Oncol 2002; 9:543–9

    Article  PubMed  Google Scholar 

  4. Erickson VW, Pearson ML, Ganz PA, Adams J, Kahn KL. Arm edema in breast cancer patients. J Natl Cancer Inst 2001; 93:96–111

    Article  PubMed  CAS  Google Scholar 

  5. Williams AF, Vadgama A, Fraks PJ, Mortimer PS. A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer–related lymphoedema. Eur J Cancer Care 2002; 11:254–61

    Article  CAS  Google Scholar 

  6. Mozes M, Pappa MZ, Karasik A, Reshef A, Adar A. The role of infection in post mastectomy lymphedema. Surg Annu 1982; 14:73–83

    PubMed  CAS  Google Scholar 

  7. McWayne J, Heiney SP. Psychologic and social sequelae of secondary lymphedema: a review. Cancer 2005; 104:457–66

    Article  PubMed  Google Scholar 

  8. Casley-Smith JR. Benzo-pyrones in the treatment of lymphoedema. Int Angiol 1999; 18:31–41

    PubMed  CAS  Google Scholar 

  9. Rockson SG, Miller LT, Senie R, American Cancer Society Lymphedema Workshop. Workgroup III: diagnosis and management of lymphedema. Cancer 1998; 83(12 Suppl American):2882–5

    Article  PubMed  CAS  Google Scholar 

  10. Casley-Smith JR, Boris M, Weindorf F, Lasinski B. Treatment for lymphedema of the Arm—the Casley-Smith method: a noninvasive method produces continued reduction. Cancer 199815; 83(12 Suppl American):2843–60

  11. Piller NB, Morgan RG, Casley-Smith JR. A double-blind cross-over trial of O-(beta hydroxyl-ethyl)-rotutsides (bezo-pyrones) in the treatment of lymphedema of the arms and legs. Br J Plastic Surg 1998; 41:20–7

    Article  Google Scholar 

  12. Filippetti M, Santoro E, Graziano F, Petric M, Rinaldi G. Modern therapeutic approaches to post-mastectomy brachial lymphedema. Microsurgery 1994; 15:604–10

    Article  PubMed  CAS  Google Scholar 

  13. Gloviczki P. Principles of surgical treatment of chronic lymphoedema. Int Angiol 1999; 18:42–6

    PubMed  CAS  Google Scholar 

  14. Huang GK, Hu RQ, Shen YL, Pan GP. Microlymphaticovenous anastamosis for lymphedema of the external genitalia in females. Surg Gynecol Obstet 1986; 162:429–32

    PubMed  CAS  Google Scholar 

  15. Foldi E. The treatment of lymphedema. Cancer 1998; 83(12 Suppl American):2833–4

    Article  PubMed  CAS  Google Scholar 

  16. Mondry TF, Riffengurgh RH, Johnstone PA. Prospective trial of complete decongestive therapy for upper extremity lymphedema after breast cancer therapy. Cancer J 2004; 10:42–8

    Article  PubMed  Google Scholar 

  17. Foldi M. On the pathopysiology of arm lymphedema after treatment of breast cancer. Lymphology 1995; 28:151–8

    PubMed  CAS  Google Scholar 

  18. Foldi E, Foldi M, Weissleder H. Conservative treatment of lymphoedema of the limbs. Angiology 1985; 36:71–80

    Google Scholar 

  19. Leduc O, Leduc A, Bourgeois P, Belgrado JP. The treatment of upper limb edema. Cancer 1998; 83(12 Suppl American):2835–9

    Article  PubMed  CAS  Google Scholar 

  20. Andersen L, Hojris I, Erlandsen M, Andersen J. Treatment of breast-cancer–related lymphedema with or without manual lymphatic drainage—a randomized study. Acta Oncol 2000; 39:399–405

    Article  PubMed  CAS  Google Scholar 

  21. Hinrichs CS, Gibbs JF, Driscoll D, et al. The effectiveness of complete decongestive therapy for the treatment of lymphedema following groin dissection for melanoma. J Surg Oncol 2004; 85:187–92

    Article  PubMed  Google Scholar 

Download references

ACKNOWLEDGMENTS

We thank Toni Wakifus, Director of Outpatient Therapy, Health South Rehabilitation Hospital, Memphis, TN; and Allison Hoehn, lymphedema therapist, and Joseph Jardina, Health South Rehabilitation Hospital.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John B. Hamner MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hamner, J.B., Fleming, M.D. Lymphedema Therapy Reduces the Volume of Edema and Pain in Patients with Breast Cancer. Ann Surg Oncol 14, 1904–1908 (2007). https://doi.org/10.1245/s10434-006-9332-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-006-9332-1

Keywords

Navigation