The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of lymphedema severity and response to CDP in breast cancer-related lymphedema (BCRL).

The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of lymphedema severity and response to CDP in breast cancer-related lymphedema (BCRL).

Jan 2013

Liao SF, Li SH, Huang HY, Chen ST, Kuo SJ, Chen DR, Wei TS.

Source

Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, 135 Nanxiao Street, Changhua 500, Taiwan. Electronic address: sueliao3@gmail.com.

Abstract

BCRL is the most common morbidity in women with breast cancer. We performed a retrospective analysis of 107 BCRL patients to identify the efficacy of CDP and the predictors of lymphedema severity and response to CDP. The patients received 12 sessions of CDP, the duration of lymphedema was 22.4 months, and 56% of BCRL occurred within 2 years after surgery. Lymphedema severity, baseline and post-CDP percentage of excess volume (PEV), was 27.7% and 14.9%. The baseline PEV was correlated with the duration of lymphedema. The CDP efficacy, percentage reduction of excess volume (PREV), was 50.5%, and was correlated with PEV, duration of lymphedema and age. Baseline lymphedemaseverity was the most important predictive factor for CDP efficacy. The breast cancer therapy characteristics did not affect PEV or PREV. This study showed the effectiveness of an intensive CDP interventions. The key to predicting successfullymphedema treatment is the baseline PEV.

Elsevier

Microsurgical Techniques for the Treatment of Breast Cancer-related Lymphedema: a Systematic Review.

Dec 2012

Penha TR, Ijsbrandy C, Hendrix NA, Heuts EM, Voogd AC, von Meyenfeldt MF, van der Hulst RR.

Source

Department of General Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.

Abstract

Background 

Upper limb lymphedema is one of the most underestimated and debilitating complications of breast cancer treatment. The aim of this review is to summarize the recent literature for evidence of the effectiveness of lymphatic microsurgery for the treatment of breast cancer-related lymphedema (BCRL).

Methods 

A search was conducted for articles published from January 2000 until January 2012. Only studies on secondary lymphedema after breast cancer treatment and those examining the effectiveness of microsurgery were included.

Results 

No randomized clinical trials or comparative studies were available. Ten case-series met inclusion criteria: (composite) tissue transfer (n = 4), lymphatic vessel transfer (n = 2), and derivative microlymphatic surgery (n = 4). Limb volume/circumference reduction varied from 2 to 50% over a follow-up time ranging from 1 to 132 months. Postoperative discontinuation rates of conservative therapy were only reported after composite tissue transfer, ranging from 33 to 100% after 3 to 24 months. Clear selection criteria for lymphatic surgery and lymphatic flow assessment were absent in most studies.

Conclusion 

We identified important methodological shortcomings of the available literature. Evidence acquired through comparative studies with uniform patient selection is lacking. Consistent positive findings with regards to limb volume reduction and limited complications are reasons to further explore these techniques in methodologically superior studies.

Thieme