John B Hamner1, Martin D Fleming. 1. Department of Surgery, University of Tennessee Health Sciences Center, 956 Court Avenue, Room G228, Memphis, Tennessee 38163, USA. jhamner@utmem.edu
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.
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 cancerpatients. 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.
Authors: Echoe M Bouta; Connor W McCarthy; Alexander Keim; Han Bing Wang; Ryan J Gilbert; Jeremy Goldman Journal: Acta Biomater Date: 2010-10-23 Impact factor: 8.947
Authors: Ruchi Sharma; Juliet A Wendt; John C Rasmussen; Kristen E Adams; Milton V Marshall; Eva M Sevick-Muraca Journal: Ann N Y Acad Sci Date: 2008 Impact factor: 5.691
Authors: Dan Li; Kirill Gromov; Steven T Proulx; Chao Xie; Jie Li; Daniel P Crane; Kjeld Søballe; Regis J O'Keefe; Hani A Awad; Lianping Xing; Edward M Schwarz Journal: Ann N Y Acad Sci Date: 2010-03 Impact factor: 5.691
Authors: Dale J Langford; Steven M Paul; Claudia West; Gary Abrams; Charles Elboim; Jon D Levine; Deborah Hamolsky; Judith A Luce; Kord M Kober; John M Neuhaus; Bruce A Cooper; Bradley E Aouizerat; Christine Miaskowski Journal: J Pain Date: 2014-12 Impact factor: 5.820
Authors: Alex P Keim; Justin R Slis; Uziel Mendez; Emily M Stroup; Yvonne Burmeister; Natalie Tsolaki; Oliver Gailing; Jeremy Goldman Journal: Lymphat Res Biol Date: 2013-06-01 Impact factor: 2.589
Authors: Mónica de la Cueva-Reguera; David Rodríguez-Sanz; César Calvo-Lobo; Silvia Fernández-Martínez; Beatriz Martínez-Pascual; Yolanda Robledo-Do-Nascimento; María Blanco-Morales; Carlos Romero-Morales Journal: Int Wound J Date: 2020-06-13 Impact factor: 3.315