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The Addition of Manual Lymph Drainage to Compression Therapy For Breast Cancer Related Lymphedema: a Randomized Controlled Trial

Breast Cancer Research and Treatment volume 86, pages 95–106 (2004)Cite this article

Abstract

Purpose. The purpose of this investigation was to compare the reduction in arm lymphedema volume achieved from manual lymph drainage massage (MLD) in combination with multi-layered compression bandaging (CB) to that achieved by CB alone.

Methods and materials. Fifty women with lymphedema (mean age of 59 years ± 13 years) were randomly assigned to 4 weeks of combined MLD/CB or CB alone. The primary study endpoint was the reduction in arm lymphedema volume, which was determined by water displacement volumetry and measurement of circumference. Independent assessors, blinded to subject treatment assignment, performed the outcome measurements.

Results. Arm lymphedema volume decreased significantly after 4 weeks irrespective of treatment assignment (p < 0.001). Individuals with mild lymphedema receiving combined MLD/CB had a significantly larger percentage reduction in volume compared to individuals with mild lymphedema receiving CB alone, and compared to individuals with moderate or severe lymphedema receiving either treatment.

Conclusion. These findings indicate that CB, with or without MLD, is an effective intervention in reducing arm lymphedema volume. The findings suggest that CB on its own should be considered as a primary treatment option in reducing arm lymphedema volume. There may be an additional benefit from the application of MLD for women with mild lymphedema; however, this finding will need to be further examined in the research setting.

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References

  1. Jungi WF: The prevention and management of lymphoedema after treatment for breast cancer. Int Rehabil Med 3: 129–134, 1981

    Google Scholar 

  2. Brennan MJ, Weitz J: Lymphedema 30 years after radical mastectomy. Am J Phys Med Rehabil 71: 12–14, 1992

    Google Scholar 

  3. Petrek JA, Lerner R: Lymphedema. In: Harris JR, Lippman ME, Morrow M, Helman S, (eds) Diseases of the Breast. Lippincott-Raven, Philadelphia, 1996, pp 896-900

    Google Scholar 

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

    Google Scholar 

  5. Brennan MJ: Lymphedema following the surgical treatment of breast cancer: a review of pathophysiology and treatment. J Pain Sympt Manage 7: 110–116, 1992

    Google Scholar 

  6. Casley-Smith JR: Alterations of untreated lymphedema and it's grades over time. Lymphology 28: 174–185, 1995

    Google Scholar 

  7. Petrek JA, Heelan MC: Incidence of breast carcinoma-related lymphedema. Cancer 83: 2776–2781, 1998

    Google Scholar 

  8. Simon MS, Cody RL: Cellulitis after axillary lymph node dissection for carcinoma of the breast. Am J Med 93: 543–548, 1992

    Google Scholar 

  9. Passik SD, McDonald MV: Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer 83: 2817–2820, 1998

    Google Scholar 

  10. Brennan MJ, DePompolo RW, Garden FH: Focused review: postmastectomy lymphedema. Arch Phys Med Rehabil 77: S74–80, 1996

    Google Scholar 

  11. Mirolo BR, Bunce IH, Chapman M, Olsen T, Eliadis P, Hennessy JM, Ward LC, Jones LC: Psychosocial benefits of postmastectomy lymphedema therapy. Cancer Nurs 18: 197–205, 1995

    Google Scholar 

  12. Tobin MB, Lacey HJ, Meyer L, Mortimer PS: The psychological morbidity of breast cancer-related arm swelling. Cancer 72: 3248–3252, 1993

    Google Scholar 

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

    Google Scholar 

  14. Voogd AC, Ververs JM, Vingerhoets AJ, Roumen RM, Coebergh JW, Crommelin MA: Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Br J Surg 90: 76–81, 2003

    Google Scholar 

  15. Brennan MJ, Miller LT: Overview of treatment options and review of the current role and use of compression garments, intermittent pumps, and exercise in the management of lymphedema. Cancer 83: 2821–2827, 1998

    Google Scholar 

  16. Rockson SG, Miller LT, Senie R, Brennan MJ, Casley-Smith JR, Foldi E, Foldi M, Gamble GL, Kasseroller RG, Leduc A, Lerner R, Mortimer PS, Norman SA, Plotkin CL, Rinehart-Ayres ME, Walder AL: American Cancer Society Lymphedema Workshop. Workgroup III: Diagnosis and management of lymphedema. Cancer 83: 2882–2885, 1998

    Google Scholar 

  17. Casley-Smith JR, Boris M, Weindorf S, Lasinski B: Treatment for lymphedema of the arm-the Casley-Smith method. Cancer 83: 2843–2860, 1998

    Google Scholar 

  18. Harris SR, Hugi MR, Olivotto IA, Levine M: Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema. Can Med Assoc J 164: 191–199, 2001

    Google Scholar 

  19. Megens A, Harris SR: Physical therapist management of lymphedema following treatment for breast cancer: a critical review of its effectiveness. Phys Ther 78: 1302–1311, 1998

    Google Scholar 

  20. Karki A, Simonen R, Malkia E, Selfe J: Efficacy of physical therapy methods and exercise after a breast cancer option: a systematic review. Crit Rev Phys Rehabil Med 13: 159–190, 2001

    Google Scholar 

  21. Casley-Smith JR: Modern treatment of lymphoedema. I. Complex physical therapy: the first 200 Australian limbs. Australas J Dermatol 33: 61–68, 1992

    Google Scholar 

  22. Ko DS, Lerner R, Klose G, Cosimi AB: Effective treatment of lymphedema of the extremities. Arch Surg 133: 452–458, 1998

    Google Scholar 

  23. Foldi E, Foldi M, Clodius L: The lymphedema chaos: a lancet. Ann Plast Surg 22: 505–515, 1989

    Google Scholar 

  24. Boris M, Weindorf S, Lasinski B, Boris G: Lymphedema reduction by noninvasive complex lymphedema therapy. Oncology (Huntington) 8: 95–106, 1994

    Google Scholar 

  25. Morgan RG, Casley-Smith JR, Mason MR: Complex physical therapy for the lymphoedematous arm. J Hand Surg-British Volume 17: 437–441, 1992

    Google Scholar 

  26. Godal R, Swedborg I: A correction for the natural asymmetry of the arms in the determination of the volume of oedema. Scand J Rehabil Med 14: 193–195, 1982

    Google Scholar 

  27. Kasseroller RG: The Vodder School: the Vodder method. Cancer 83: 2840–2842, 1998

    Google Scholar 

  28. Tracey GD, Reeve TS, Fitzsimons E, Rundle FF: Observations on the swollen arm after radical mastectomy. Aust N Z J Surg 30: 204, 1961

    Google Scholar 

  29. Engler HS, Sweat RD: Volumetric arm measurements: technique and results. Am Surg 28: 465–468, 1962

    Google Scholar 

  30. Karges JR: Assessing the relationship between water displacement and circumferential measurements in determining upper extremity volume in women with lymphedema. Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, USA, 1996

    Google Scholar 

  31. Portney LG, Watkins MP: Foundations of Clinical Research Applications to Clinical Practice. Appleton and Lange, East Norwalk, Connecticut, 1993

    Google Scholar 

  32. Warren S: Statistical Analysis. In: Bartlett D (ed) Research Theory in Rehabilitation. Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, 1994.

    Google Scholar 

  33. Stillwell GK: Treatment of postmastectomy lymphedema. Mod Treat 6: 396–412, 1969

    Google Scholar 

  34. Andersen L, Hojris I, Erlandsen M, Andersen J: Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage-a randomized study. Acta Oncol 39: 399–405, 2000

    Google Scholar 

  35. Johansson K, Albertsson M, Ingvar C, Ekdahl C: Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema. Lymphology 32: 103–10, 1999

    Google Scholar 

  36. Badger CM, Peacock JL, Mortimer PS: 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: 2832–2837, 2000

    Google Scholar 

  37. Klose G: Lymphedema Bandaging. Lohmann & Rauscher, Germany, 1998, pp 14-23

    Google Scholar 

  38. Ramos SM, O'Donnell LS, Knight G: Edema volume, not timing, is the key to success in lymphedema treatment. Am J Surg 178: 311–315, 1999

    Google Scholar 

  39. Leduc O, Leduc A, Bourgeois P, Belgrado JP: The physical treatment of upper limb edema. Cancer 83: 2835–2839, 1998

    Google Scholar 

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, Canada, T6G 1Z2

    Margaret L. McNeely

  2. Faculty of Rehabilitation Medicine, Department of Physical Therapy, Cross Cancer Institute, Edmonton, Alberta, Canada

    David J. Magee & Mark Haykowsky

  3. Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada

    Alan W. Lees

  4. Faculty of Medicine, Department of Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada

    Alan W. Lees

  5. Faculty of Medicine, Division of Anatomy, Cross Cancer Institute, Edmonton, Alberta, Canada

    Keith M. Bagnall

  6. Division of Epidemiology, Cross Cancer Institute, Edmonton, Alberta, Canada

    John Hanson

Authors
  1. Margaret L. McNeely
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  2. David J. Magee
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  3. Alan W. Lees
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  4. Keith M. Bagnall
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  5. Mark Haykowsky
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  6. John Hanson
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Correspondence to Margaret L. McNeely.

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McNeely, M.L., Magee, D.J., Lees, A.W. et al. The Addition of Manual Lymph Drainage to Compression Therapy For Breast Cancer Related Lymphedema: a Randomized Controlled Trial. Breast Cancer Res Treat 86, 95–106 (2004). https://doi.org/10.1023/B:BREA.0000032978.67677.9f

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  • DOI: https://doi.org/10.1023/B:BREA.0000032978.67677.9f

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