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A systematic review of the effect of low-level laser therapy in the management of breast cancer-related lymphedema

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Abstract

Purpose

The purpose of this study was to review the effect of low-level laser therapy (LLLT) in the management of breast cancer-related lymphedema (BCRL).

Methods

A systematic review of seven databases for clinical trials for LLLT in the management of BCRL published between 1990 and 2011 was performed.

Results

A total of eight studies on 230 patients were found. The methodological qualities of the selected studies were assessed with the Physiotherapy Evidence Database scale, and the studies were categorized according to Sackett’s levels of evidence. Five studies were graded at evidence level II. Two studies were graded at evidence level III, and the remaining study was graded at evidence level V.

Conclusions

There is moderate to strong evidence for the effectiveness of LLLT for the management of BCRL from five small studies of acceptable methodological quality. A dose of 1–2 J/cm2 per point applied to several points covering the fibrotic area can reduce limb volume following BCRL. Further well-designed, large-scale studies are required to determine more precisely how effective LLLT may be in BCRL.

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References

  1. Clark B, Sttzia J, Harlow W (2005) Incidence and risk of arm edema following treatment for breast cancer: a three-year follow-up study. Q J Med 98:343–348

    Article  CAS  Google Scholar 

  2. Ozaslan C, Kuru B (2004) Lymphedema after treatment of breast cancer. Am J Surg 187:69–72

    Article  PubMed  Google Scholar 

  3. Lee T, Kilbreath S, Refshauge K, Herbert R, Beith J (2008) Prognosis of the upper limb following surgery and radiation for breast cancer. Breast Cancer Res Treat 110:19–37

    Article  PubMed  Google Scholar 

  4. Hayes SC, Janda M, Cornish B, Battistutta D, Newman B (2008) Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol 26:3536–3542

    Article  PubMed  Google Scholar 

  5. Petrek JA, Heelan MC (1998) Incidence of breast carcinoma-related lymphedema. Cancer 12(Suppl):2776–2781

    Article  Google Scholar 

  6. Erickson VS, Pearson ML, Ganz PA, Adams J, Kahn KL (2001) Arm edema in breast cancer patients. J Natl Cancer Inst 93(2):96–111

    Article  PubMed  CAS  Google Scholar 

  7. Soran A, D’Angelo G, Begovic M, Ardic F, Harlak A, Samuel Wieand H et al (2006) Breast cancer-related lymphedema—what are the significant predictors and how they affect the severity of lymphedema? Breast J12:536–543

    Google Scholar 

  8. Casley-Smith JR, Casley-Smith JR (1994) Volume alterations in lymphedema; untreated, and after complex therapy (C.P.T), benzo-pyrones, or both. Lymphology 27(suppl):627–631

    Google Scholar 

  9. Karki A, Simonen R, Malkia E, Selfe J (2005) Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation. J Rehabil Med 37:180–188

    PubMed  Google Scholar 

  10. Gossenlink R, Rouffaer L, Vanhelden P, Piot W, Trooster T, Christiaens M (2003) Recovery of upper limb function after axillary dissection. J Surg Oncol 83:204–211

    Article  Google Scholar 

  11. Rietman JS, Dijkstra PU, Geertzen JH, Baas P, De-Vries J, Dolsma WV et al (2004) Treatment-related upper limb morbidity 1 year after sentinel lymph node biopsy or axillary lymph node dissection for stage I or II breast cancer. Ann Surg Oncol 11:1018–1024

    Article  PubMed  CAS  Google Scholar 

  12. Clodius L (2002) Lymphedema common sense. Eur J Plast Surg 25:66–80

    Article  Google Scholar 

  13. Velanovich V, Szymanski W (1999) Quality of life of breast cancer patients in lymphedema. Am J Surg 177:184–187

    Article  PubMed  CAS  Google Scholar 

  14. Olszewski W (2000) Clinical efficacy of micronized purified flavonoid fraction (MPFF) in edema. Angiology 51:25–29

    Article  PubMed  CAS  Google Scholar 

  15. Badger CM, Peacock JL, Mortimer PS (2000) A randomized, controlled, parallel-group clinical trial comparing multilayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Cancer 88:2832–8327

    Article  PubMed  CAS  Google Scholar 

  16. Szuba A, Cooke JP, Yousuf S, Rockson SG (2000) Decongestive lymphatic therapy for patients with cancer-related or primary lymphedema. Am J Med 109:296–300

    Article  PubMed  CAS  Google Scholar 

  17. Dini D, Del Mastro L, Gozza A (1998) The role of pneumatic compression in the treatment of postmastectomy lymphedema. A randomized phase III study. Ann Oncol 9:187–190

    Article  PubMed  CAS  Google Scholar 

  18. Foldi E (1998) The treatment of lymphedema. Cancer 83:2833–2834

    Article  PubMed  CAS  Google Scholar 

  19. Casley-Smith J, Casley-Smith JR (1997) The cost efficiencies of various treatments for lymphoedema. In: Casley-Smith J, Casley-Smith JR (eds) Modern treatment for lymphoedema. The Lymphedema Association of Australia, Adelaide, pp 296–304

    Google Scholar 

  20. Balzarini A, Pirovano C, Diazzi G et al (1993) Ultrasound therapy of chronic arm lymphedema after surgical treatment of breast cancer. Lymphology 26:128–134

    PubMed  CAS  Google Scholar 

  21. Can J, Li S, Cai R, Chang T (1996) Microwave heating in the management of post mastectomy upper limb lymphedema. Ann Plast Surg 36:576–580

    Article  Google Scholar 

  22. Piller NB, Thelander A (1995) Treating chronic postmastectomy lymphedema with low level laser therapy: a cost effective strategy to reduce severity and improve quality of survival. Laser Ther 7:163–168

    Article  Google Scholar 

  23. Piller NB, Thelander A (1998) Treatment of chronic postmastectomy lymphedema with low level laser therapy: a 2.5 year follow-up. Lymphology 31:74–86

    PubMed  CAS  Google Scholar 

  24. Carati CJ, Anderson SN, Gannon BJ, Piller NB (2003) Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer 98:1114–1122

    Article  PubMed  Google Scholar 

  25. Kaviani A, Fateh M, Nooraie RY, Alinagizadeh MR, Ataie-Fashtami L (2006) Low-level laser therapy in management of postmastectomy lymphedema. Lasers Med Sci 21:90–94

    Article  PubMed  Google Scholar 

  26. Kozanoglu E, Basaran S, Paydas S, Sarpel T (2009) Efficacy of pneumatic compression and low-level laser therapy in the treatment of postmastectomy lymphedema: a randomized controlled trial. Clin Rehabil 23:117–124

    Article  PubMed  Google Scholar 

  27. Lau RW, Cheing GL (2009) Managing postmastectomy lymphedema with low-level laser therapy. Photomed Laser Surg 27:763–769

    Article  PubMed  Google Scholar 

  28. Dirican A, Andacoglu O, Johnson R, McGuire K, Mager L, Soran A (2011) The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema. Support Care Cancer 19:685–690

    Article  PubMed  Google Scholar 

  29. Omar MT, Ebid AA, El Morsy AM (2011) Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study. J Surg Res 165:82–90

    Article  Google Scholar 

  30. Lievens PC (1985) The influence of laser-irradiation on the motoricity of the lymphatic system and on the wound healing process. In: Proceedings from the International Congress on Laser in Medicine and Surgery, Bologna, 26–28 June: 171–4

  31. Lievens PC (1991) The effect of combined HeNe and I.R. laser treatment on the regeneration of the lymphatic system during the process of wound healing. Lasers Med Sci 6:93–99

    Google Scholar 

  32. Cormier J, Feldman J, Askew A, Beck M, Bernas M, Francis K et al (2010) ALFP to update the best practice document. J Lymphedema 5:68–71

    Google Scholar 

  33. Moseley AL, Carati CJ, Piller NB (2007) A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol 18:639–646

    Article  PubMed  CAS  Google Scholar 

  34. Sackett DL (1989) Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 95(suppl2):2S–4S

    PubMed  CAS  Google Scholar 

  35. Se S, Richardson WS, Glasziou P, Haynes RB (2002) Evidence based medicine: how to practice and teach EBM, 3rd edn. Elsevier Churchill Livingstone, Edinburgh

    Google Scholar 

  36. Sitzia J, Stanton AB, Badger C (1997) A review of outcome indicators in the treatment of chronic limb edema. Clin Rehabil 11:181–191

    Article  PubMed  CAS  Google Scholar 

  37. Armer J, Fu MR (2005) Age differences in post-breast cancer lymphedema signs and symptoms. Cancer Nurs 28(3):200–207

    Article  PubMed  Google Scholar 

  38. Wilke LG, McCall LM, Posther KE, Whitworth PW, Reintgen DS, Leitch AM et al (2006) Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol 13(4):491–500

    Article  PubMed  Google Scholar 

  39. Piper MC (1990) Efficacy of physical therapy: rate of motor development in children with cerebral palsy. Pediatr Phys Ther 2:126–130

    Article  Google Scholar 

  40. Bobyd S, Brooks D, Agnew-Coughlin J, Ashwell J (1994) Evaluation of the literature on the effectiveness of physical therapy modalities in the management of children with cystic fibrosis. Pediatr Phys Ther 6:70–74

    Google Scholar 

  41. Verhagen A, de Vet H, de Bie R et al (1998) The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol 51:1235–1241

    Article  PubMed  CAS  Google Scholar 

  42. Maher CG, Sherrington C, Herbert R et al (2003) Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 83:713–721

    PubMed  Google Scholar 

  43. Harris SR (1996) How should treatments be critiqued for scientific merit? Phys Ther 76:175–181

    PubMed  CAS  Google Scholar 

  44. Oasevich IA, Shargorodskii AG (1999) Low intensity infrared laser in the diagnosis and combined treatment of acute non-specific lymphadenitis of the face and neck in children. Stomatologia 78:28–30

    CAS  Google Scholar 

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Authors and Affiliations

  1. Physical Therapy Department for Surgery, Faculty of Physical Therapy, Cairo University, 7 Ahmed Elziat Street, Giza, Egypt

    Mohammed Taher Ahmed Omar

  2. Rehabilitation Research Chair, King Saud University, Riyadh, Saudi Arabia

    Mohammed Taher Ahmed Omar & Afaf Ahmed Mohamed Shaheen

  3. Basic Sciences Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt

    Afaf Ahmed Mohamed Shaheen

  4. Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia

    Hamayun Zafar

  5. Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden

    Hamayun Zafar

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  1. Mohammed Taher Ahmed Omar
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  2. Afaf Ahmed Mohamed Shaheen
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  3. Hamayun Zafar
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Correspondence to Mohammed Taher Ahmed Omar.

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Omar, M.T.A., Shaheen, A.A.M. & Zafar, H. A systematic review of the effect of low-level laser therapy in the management of breast cancer-related lymphedema. Support Care Cancer 20, 2977–2984 (2012). https://doi.org/10.1007/s00520-012-1546-0

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  • DOI: https://doi.org/10.1007/s00520-012-1546-0

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