Ann Rehabil Med.  2013 Oct;37(5):690-697. 10.5535/arm.2013.37.5.690.

Long-Term Effects of Complex Decongestive Therapy in Breast Cancer Patients With Arm Lymphedema After Axillary Dissection

• Hwang JM
• Hwang JH
• Kim TW
• Lee SY
• Chang HJ
• Chu IH

• KMID: 2266587
• DOI: http://doi.org/10.5535/arm.2013.37.5.690

Abstract

OBJECTIVE
To investigate the long-term effects of complex decongestive therapy (CDT) on edema reduction in breast cancer-related lymphedema patients after axillary dissection, according to the initial volume of edema.
METHODS
A retrospective review of 57 patients with unilateral arm after an axillary dissection for breast cancer was performed. The patients, treated with two weeks of CDT and self-administered home therapy, were followed for 24 months. Arm volume was serially measured by using an optoelectronic volumeter prior to and immediately after CDT; and there were follow-up visits at 3, 6, 12, and 24 months. Patients were divided into two groups according to the percent excess volume (PEV) prior to CDT: group 1, PEV<20% and group 2, PEV> or =20%.
RESULTS
In group 1, mean PEV before CDT was 11.4+/-5.0% and 14.1+/-10.6% at 24 months after CDT with no significant difference. At the end of CDT, PEV was 28.8+/-15.7% in group 2, which was significantly lower than the baseline (41.9+/-19.6%). The reduction of PEV was maintained for 24 months in group 2.
CONCLUSION
The long-term effects of CDT were well-maintained for 24 months, but there was a difference in progression of PEV between the two groups. The patients with more initial PEV showed significant volume-reducing effects of CDT. In patients with less initial PEV, the severity of lymphedema did not progress to higher grades.

Keyword

Lymphedema; Physical therapy modalities; Breast neoplasms

MeSH Terms

Arm*
Breast Neoplasms*
Breast*
Edema
Follow-Up Studies
Humans
Lymphedema*
Physical Therapy Modalities
Retrospective Studies

Figure

• 

  Fig. 1 Distribution of percent excess volume (PEV) at study time points. At months 3, 6, 12, and 24 after CDT, the PEV in group 2 (PEV≥20%) was significantly lower than at the baseline, but no significant difference was seen in group 1 (PEV<20%). Error bars indicate a standard deviation. CDT, complex decongestive therapy; pre-CDT, prior to CDT; post-CDT, right after CDT. *p<0.05, comparison with pre-CDT.

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