Effectiveness of complete decongestive therapy (CDT) in managing secondary lymphedema after modified radical mastectomy (MRM)
| Autor: | Mullai Dhinakaran, Kamlakshi Esther Benjamin, Kunal Jain |
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| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 30:e19622-e19622 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2012.30.15_suppl.e19622 |
| Popis: | e19622 Background: Lymphedema of ipsilateral arm is one of the common complications seen after MRM with varying incidence reported in literature ranging from 5% to 56%. Several therapeutic interventions exist to treat this potentially distressing and disabling condition, but no consensus regarding definitive treatment of lymphedema has been reached. Methods: We conducted a single centre, prospective pilot study in patients with secondary lymphedema developed after treatment of breast cancer. These subjects were selected according to predefined criteria with duly signed consent form, from Outpatient Department of Physiotherapy, Christian Medical College and Hospital, Ludhiana. Lymphedema assessment with limb volume measurement was done using modified truncated cone method. A daily intervention program of CDT was implemented consisting of education about skin care, manual lymph drainage techniques, compression garments and exercise for 45 minutes per day for 10 days. The patients were assessed at baseline and on 10th day. During this10 day supervised therapy in the hospital, patients were also trained to continue this therapy at home. Results: Fifteen patients have been enrolled prospectively in this study between March 2011 and December 2011. The mean age at presentation was 43.5 yrs (range 35-58 yrs). All patients underwent MRM and the mean duration of presentation from the time of MRM to development of lymphedema was 12.5 months (3-24 months). The mean pre-treatment volumes of normal and affected arms were 332.47mL (240-425mL) and 416.62mL (277.6-535.5 mL) respectively (p=0.004). Mean post treatment volume of affected limb at the end of 10th day was 329.93mL (249-400mL) showing an absolute reduction in mean volume of affected arm by 86.69 mL (p=0.02). Conclusions: Complete decongestive therapy was helpful in significant reduction of secondary lymphedema after MRM in this small patient group. These findings need to be verified in a larger sample size comparing other modalities used in managing lymphedema. CDT needs to be tested in early post-operative setting to assess its role in decreasing incidence of lymphedema after MRM. |
| Databáze: | OpenAIRE |
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