Combined Decongestive Therapy and Reduction of Pain and Heaviness in Patients with Breast Cancer-related Lymphedema

Purpose: We aimed to determine the effectiveness of combined decongestive therapy (CDT) and the minimum sessions required to significantly reduce pain and heaviness in patients with breast cancer-related lymphedema.

Methods: A sample of 169 patients with breast cancer-related lymphedema underwent CDT, 5 days/week for a total of 3 to 4 weeks. Self-reported pain and heaviness was quantified on a separate visual analog scale (VAS) prior to CDT and after 3, 5, 7, 10, and 15 sessions. Scores derived from VASs were categorized into three categories: mild (score < 4), moderate (score = 4-6), and severe (score > 6). Downward transition for at least one category in severity of each parameter was considered as an improvement. Repeated measure analysis of variance was conducted to test the effect of time on the severities of pain and heaviness while age, afflicted side with lymphedema, history of chemotherapy, and radiotherapy were considered as covariates.

Results: The mean age of patients was 52.66 ± 12.20 years. In all 132 patients, out of 169 patients (71.3%) reported pain and 155 patients (83.7%) reported heaviness at baseline. However, after intervention, the cumulative percentage of patients with at least a one category reduction in pain and heaviness was 86.4% and 83%, respectively. At least seven sessions of CDT were shown to be sufficient in alleviating the severity of the symptoms in greater than 83% of patients.

Conclusions: The combined decongestive therapy significantly reduced the intensities of pain and heaviness in patients with breast cancer-related lymphedema.