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Medline ® Abstract for Reference 49

of 'Clinical staging and conservative management of peripheral lymphedema'

Lymphedema therapy reduces the volume of edema and pain in patients with breast cancer.
Hamner JB, Fleming MD
Ann Surg Oncol. 2007;14(6):1904.
BACKGROUND: Despite recent advances in breast-conserving surgery, upper-extremity lymphedema remains a problem for patients after the treatment of breast cancer. This study examines the results of a protocol of therapy for lymphedema in breast cancer patients.
METHODS: A total of 135 patients with lymphedema after breast cancer treatment were provided a protocol of complete decongestive therapy (CDT). This involved manual lymphatic drainage, compression garments, skin care, and range-of-motion exercises. Therapy was divided into an induction phase involving twice-weekly therapy for 8 weeks and maintenance therapy individualized to patient needs. Absolute volume and percentage of volume of lymphedema was compared before and after treatment. Also assessed was the degree of chronic pain and the need for pain medication.
RESULTS: Mean initial lymphedema volume was 709 mL, and the percentage of lymphedema was 31%. The induction phase of CDT reduced this to 473 mL and 18%, respectively. Before therapy, 76 patients had chronic pain and 41 required oral pain medication. CDT reduced this to 20 and 11, respectively. Thedegree of pain was also assessed on a numerical scale from 0 to 10. Those patients with chronic pain initially rated their pain at an average of 6.9. After treatment, this was reduced to 1.1.
CONCLUSIONS: Lymphedema continues to be a problem for patients with breast cancer. A program of lymphedema therapy can reduce the volume of edema and reduce pain in this population.
Department of Surgery, University of Tennessee Health Sciences Center, 956 Court Avenue, Room G228, Memphis, Tennessee 38163, USA. jhamner@utmem.edu