Breast Cancer Research and Treatment

, Volume 75, Issue 1, pp 51–64

Physiotherapy After Breast Cancer Surgery: Results of a Randomised Controlled Study to Minimise Lymphoedema


  • Robyn C. Box
    • Department of PhysiotherapyUniversity of Queensland
    • School of PhysiotherapyLa Trobe University
  • Hildegard M. Reul-Hirche
    • Department of PhysiotherapyRoyal Brisbane and Women's Hospital
  • Joanne E. Bullock-Saxton
    • Department of PhysiotherapyUniversity of Queensland
  • Colin M. Furnival
    • Royal Brisbane and Wesley Hospitals

DOI: 10.1023/A:1016591121762

Cite this article as:
Box, R.C., Reul-Hirche, H.M., Bullock-Saxton, J.E. et al. Breast Cancer Res Treat (2002) 75: 51. doi:10.1023/A:1016591121762


The development of secondary arm lymphoedema after the removal of axillary lymph nodes remains a potential problem for women with breast cancer. This study investigated the incidence of arm lymphoedema following axillary dissection to determine the effect of prospective monitoring and early physiotherapy intervention. Sixty-five women were randomly assigned to either the treatment (TG) or control group (CG) and assessments were made preoperatively, at day 5 and at 1, 3, 6, 12 and 24 months postoperatively. Three measurements were used for the detection of arm lymphoedema: arm circumferences (CIRC), arm volume (VOL) and multi-frequency bioimpedance (MFBIA). Clinically significant lymphoedema was confirmed by an increase of at least 200 ml from the preoperative difference between the two arms. Using this definition, the incidence of lymphoedema at 24 mo. was 21%, with a rate of 11% in the TG compared to 30% in the CG. The CIRC or MFBIA methods failed to detect lymphoedema in up to 50% of women who demonstrated an increase of at least 200 ml in the VOL of the operated arm compared to the unoperated arm. The physiotherapy intervention programme for the TG women included principles for lymphoedema risk minimisation and early management of this condition when it was identified. These strategies appear to reduce the development of secondary lymphoedema and alter its progression in comparison to the CG women. Monitoring of these women is continuing and will determine if these benefits are maintained over a longer period for women with early lymphoedema after breast cancer surgery.

breast cancerlymphoedemaphysiotherapyrisk minimisation

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© Kluwer Academic Publishers 2002