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Long-Term Management of Breast Cancer-Related Lymphedema after Intensive Decongestive Physiotherapy

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Abstract

Background

Treatment of lymphedema is based on intensive decongestive physiotherapy followed by a long-term maintenance treatment. We analyzed the factors influencing lymphedema volume during maintenance treatment.

Method

Prospective cohort of 537 patients with secondary arm lymphedema were recruited in a single lymphology unit and followed for 12 months. Lymphedema volume was recorded prior to and at the end of intensive treatment, and at month 6 and month 12 follow-up visits. Multivariate models were fitted to analyze the respective role of the three components of complete decongestive therapy, i.e. manual lymph drainage, low stretch bandage, and elastic sleeve, on lymphedema volume during the 1-year maintenance phase therapy.

Results

Mean volume of lymphedema was 1,054 ± 633 ml prior and 647 ± 351 ml after intensive decongestive physiotherapy. During the 1-year maintenance phase therapy, the mean lymphedema volume slightly increased (84 ml—95% confidence interval [CI]: 56–113). Fifty-two percent of patients had their lymphedema volume increased above 10% from their value at the end of the intensive decongestive physiotherapy treatment phase. Non-compliance to low stretch bandage and elastic sleeve were risk factors for an increased lymphedema after 1-year of maintenance treatment (RR: 1.55 [95% CI: 1.3–1.76]; P < 0.0001 and RR: 1.61 (95% CI: 1.25–1.82); P = 0.002, respectively). Non-compliance to MLD was not a risk factor (RR: 0.99 [95% CI: 0.77–1.2]; P = 0.91).

Conclusion

During maintenance phase after intensive decongestive physiotherapy, compliance to the use of elastic sleeve and low stretch bandage should be required to stabilize lymphedema volume.

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Authors and Affiliations

  1. Department of Lymphology, Hôpital Cognacq-Jay, Site Broussais, 102 rue Didot, 75014, Paris, France

    Stéphane Vignes & Maria Arrault

  2. Department of Biostatistics and Medical Informatics, Hopital Saint-Louis AP-HP, Université Paris 7, Inserm U717, Paris, France

    Raphaël Porcher

  3. Department of Dermatology 2, Hôpital Saint Louis AP-HP, 1 Avenue Claude Vellefaux, 75475 , Paris Cedex 10, France

    Alain Dupuy

Authors
  1. Stéphane Vignes
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  2. Raphaël Porcher
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  3. Maria Arrault
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  4. Alain Dupuy
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Correspondence to Stéphane Vignes.

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Vignes, S., Porcher, R., Arrault, M. et al. Long-Term Management of Breast Cancer-Related Lymphedema after Intensive Decongestive Physiotherapy. Breast Cancer Res Treat 101, 285–290 (2007). https://doi.org/10.1007/s10549-006-9297-6

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  • DOI: https://doi.org/10.1007/s10549-006-9297-6

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