The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema

Abstract

Background

Breast-cancer-related lymphedema (BCRL) is a chronic disease, and currently there is no definitive treatment for it. There are some therapeutic interventions targeted to decrease the limb swelling and the associated problems. Low-level laser therapy (LLLT) has been used in the treatment of post-mastectomy lymphedema since 2007 in the US. The aim of this study is to review our short-term experience with LLLT in the treatment of BCRL.

Method

Seventeen BCRL patients referred to our lymphedema program between 2007 and 2009 were enrolled in this study. All patients had experienced at least one conventional treatment modality such as complex physical therapy, manual lymphatic drainage, and/or pneumatic pump therapy. LLLT was added to patients' ongoing therapeutic regimen. All patients completed the full course of LLLT consisting of two cycles. The difference between sums of the circumferences of both affected and unaffected arms (ΔC), pain score, scar mobility, and range of motion were measured before and after first and second cycles of LLLT sequentially.

Results

All patients were female with a median age of 51.8 (44–64) years. ΔC decreased 54% (15–85%) and 73% (33–100%), after the first and second cycles of LLLT, respectively. Fourteen out of seventeen experienced decreased pain with motion by an average of 40% (0–85%) and 62.7% (0–100%) after the first and second cycle of LLLT, respectively. Three patients had no improvement in pain after LLLT. Scar mobility increased in 13 (76.4%) and shoulder range of motion improved in 14 (82.3%) patients after LLLT. One patient developed cellulitis during LLLT.

Conclusion

Patients with BCRL received additional benefits from LLLT when used in conjunction with standard lymphedema treatment. These benefits include reduction in limb circumference, pain, increase in range of motion and scar mobility. Additionally, two cycles of LLLT were found to be superior to one in this study.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Petrek JA, Heelan MC (2002) Incidence of breast carcinoma related lymphedema. Cancer 83:2776–2781

    Article  Google Scholar 

  2. 2.

    Schrenk P, Rieger R, Shamiyeh A, Wayand W (2000) Morbidity following sentinal lymph node versus axillary lymph node dissection for patients with patients with breast carcinoma. Cancer 88:608–614

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Deutsch M, Flickinger JC (2003) Arm edema after lumpectomy and breast irradiation. Am J Clin Oncol 26:229–231

    PubMed  Article  Google Scholar 

  4. 4.

    Harris SR, Hugi MR, Olivotto IA, Levine M, Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer (2001) Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema. CMAJ 164:191–199

    PubMed  CAS  Google Scholar 

  5. 5.

    Donegan W, Spratt J (2002) Surgical techniques. In: Cancer of the breast, 5th edn Saunders, Philadelphia, pp 601–638

  6. 6.

    Soran A, D'Angelo G, Begovic M, Ardic F, Harlak A, Samuel Wieand H, Vogel VG, Johnson RR (2006) Breast cancer related lymphedema—what are the significant predictors and how they affect the severity of lymphedema? Breast J 6:536–543

    Article  Google Scholar 

  7. 7.

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

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    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

    PubMed  Article  Google Scholar 

  9. 9.

    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 

  10. 10.

    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

    PubMed  Article  Google Scholar 

  11. 11.

    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

    PubMed  Article  Google Scholar 

  12. 12.

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

    PubMed  Article  Google Scholar 

  13. 13.

    Williamson A, Hoggart B (2005) Pain: a review of the three commonly used pain rating scales. J Clin Nurs 14:798–804

    PubMed  Article  Google Scholar 

  14. 14.

    Hayes K, Walton JR, Szomor ZR, Murrell GA (2001) Reliability of five methods for assessing shoulder range of motion. Aust J Physiother 47:289–294

    PubMed  CAS  Google Scholar 

  15. 15.

    Vercelli S, Ferriero G, Sartorio F, Stissi V, Franchignoni F (2009) How to assess postsurgical scars: a review of outcome measures. Disabil Rehabil 31:2055–2063

    PubMed  Article  Google Scholar 

  16. 16.

    Ekim A, Armagan O, Tascioglu F, Oner C, Colak M (2007) Effect of low level laser therapy in rheumatoid arthritis patients with carpal tunnel syndrome. Swiss Med Wkly 137:347–352

    PubMed  Google Scholar 

  17. 17.

    Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M (2003) Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med 32:233–238

    PubMed  Article  Google Scholar 

  18. 18.

    Nouri K, Jimenez GP, Harrison-Balestra C, Elgart GW (2003) 585-nm pulsed dye laser in the treatment of surgical scars starting on the suture removal day. Dermatol Surg 29:65–73

    PubMed  Article  Google Scholar 

  19. 19.

    Ortu P, LaMuraglia GM, Roberts WG, Flotte TJ, Hasan T (1992) Photodynamic therapy of arteries. A novel approach for treatment of experimental intimal hyperplasia. Circulation 85:1189–1196

    PubMed  CAS  Google Scholar 

  20. 20.

    Honmura A, Ishii A, Yanase M, Obata J, Haruki E (1993) Analgesic effect of Ga-Al-As diode laser irradiation on hyperalgesia in carrageenin-induced inflammation. Lasers Surg Med 13:463–469

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Piller NB, Thelander A (1996) Low level laser therapy: a cost effective treatment to reduce post mastectomy lymphedema. Lymphology 29:297–300

    Google Scholar 

Download references

Acknowledgment

The authors would like to thank Ryan Kelley, BA, for his efforts in the editing processes and maintaining the database for our research purposes.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Atilla Soran.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Dirican, A., Andacoglu, O., Johnson, R. et al. The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema. Support Care Cancer 19, 685–690 (2011). https://doi.org/10.1007/s00520-010-0888-8

Download citation

Keywords

  • Low-level laser therapy
  • Breast cancer
  • Lymphedema