The Results of the Intensive Phase of Complete Decongestive Therapy and the Determination of Predictive Factors for Response to Treatment in Patients with Breast Cancer Related-lymphedema

Overview

Journal Cancer Rep (Hoboken)

Specialty Oncology

Date 2020 Jul 17

PMID 32672004

Citations 5

Authors

Dilek Keskin

Meltem Dalyan

Sibel Unsal-Delialioglu

Ulku Duzlu-Ozturk

Affiliations

Soon will be listed here.

Abstract

Background: Lymphedema is a common complication of breast cancer or its treatment. The gold standard treatment for lymphedema is complete decongestive therapy. There are few studies about the predictive factors for the effectiveness of complete decongestive therapy.

Aim: To evaluate the results of the intensive phase of complete decongestive therapy, and to determine the predictive factors for the response to treatment in patients with breast cancer-related lymphedema.

Methods And Results: Fifty-seven patients with breast cancer-related lymphedema (mean age: 56.2 ± 11.2 years) who underwent complete decongestive therapy between 2014 and 2016 were evaluated retrospectively. Extremity volume was calculated using circumferential measurements and the truncated cone formula technique. Response to treatment was evaluated using the percentage reduction of excess volume formula, which was obtained by calculating the extremity volume before and after treatment. The median percentage reduction of excess volume was 27.7% (IQR,13.6-50.3). The history of skin infection was related to lower percentage reduction of excess volume (P = 0.001). Although percentage reduction of excess volume was positively correlated with education level (r = 0.286, P = 0.031), percentage reduction of excess volume was negatively correlated with lymphedema duration (r = -0.361, P = 0.006), postoperative duration (r = -0.314, P = 0.018), percentage of excess volume (r = -0.398, P = 0.002), and number of complete decongestive therapy sessions (r = -0.436, P = 0.001). Univariate and multivariate analyses showed that the independent variables for percentage reduction of excess volume were percentage of excess volume (P = 0.009) and education level (P = 0.021).

Conclusion: Complete decongestive therapy is an effective method in patients with breast cancer related-lymphedema. The most important predictive factors for the efficacy of treatment were found as percentage of excess volume and education level. Patients with breast cancer should be followed up regularly and receive complete decongestive therapy in the early stage of lymphedema.

Citing Articles

Conservative medical intervention as a complement to CDT for BCRL therapy: a systematic review and meta-analysis of randomized controlled trials.

Deng C, Wu Z, Cai Z, Zheng X, Tang C Front Oncol. 2024; 14:1361128.

PMID: 38737896 PMC: 11082302. DOI: 10.3389/fonc.2024.1361128.

Pre- and Post-Microsurgical Rehabilitation Interventions and Outcomes on Breast Cancer-Related Lymphedema: a Systematic Review.

Doubblestein D, Campione E, Hunley J, Schaverien M Curr Oncol Rep. 2023; 25(9):1031-1046.

PMID: 37402044 PMC: 10474983. DOI: 10.1007/s11912-023-01439-9.

Comments to "The Randomized Controlled Study of Low-Level Laser Therapy, Kinesio-Taping and Manual Lymphatic Drainage in Patients With Stage II Breast Cancer-Related Lymphedema".

Bergmann A, Andrade M, Dias M Eur J Breast Health. 2023; 19(2):184-185.

PMID: 37025573 PMC: 10071891. DOI: 10.4274/ejbh.galenos.2023.2023-1-2.

What do we know about treating breast-cancer-related lymphedema? Review of the current knowledge about therapeutic options.

Anuszkiewicz K, Jankau J, Kur M Breast Cancer. 2022; 30(2):187-199.

PMID: 36571707 PMC: 9950281. DOI: 10.1007/s12282-022-01428-z.

The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related-lymphedema.

Keskin D, Dalyan M, Unsal-Delialioglu S, Duzlu-Ozturk U Cancer Rep (Hoboken). 2020; 3(2):e1225.

PMID: 32672004 PMC: 7941528. DOI: 10.1002/cnr2.1225.

References

Ramos S, ODonnell L, Knight G . Edema volume, not timing, is the key to success in lymphedema treatment. Am J Surg. 1999; 178(4):311-5. DOI: 10.1016/s0002-9610(99)00185-3. View

Johansson K, Branje E . Arm lymphoedema in a cohort of breast cancer survivors 10 years after diagnosis. Acta Oncol. 2010; 49(2):166-73. DOI: 10.3109/02841860903483676. View

Bar Ad V, Dutta P, Solin L, Hwang W, Tan K, Both S . Time-course of arm lymphedema and potential risk factors for progression of lymphedema after breast conservation treatment for early stage breast cancer. Breast J. 2012; 18(3):219-25. DOI: 10.1111/j.1524-4741.2012.01229.x. View

Stamatakos M, Michael S, Stefanaki C, Charikleia S, Kontzoglou K, Konstantinos K . Lymphedema and breast cancer: a review of the literature. Breast Cancer. 2011; 18(3):174-80. DOI: 10.1007/s12282-010-0246-1. View

Huang T, Tseng S, Lin C, Bai C, Chen C, Hung C . Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol. 2013; 11:15. PMC: 3562193. DOI: 10.1186/1477-7819-11-15. View

Keskin D, Dalyan M, Unsal-Delialioglu S, Duzlu-Ozturk U . The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related-lymphedema. Cancer Rep (Hoboken). 2020; 3(2):e1225. PMC: 7941528. DOI: 10.1002/cnr2.1225. View

Korpan M, Crevenna R, Fialka-Moser V . Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients. Am J Phys Med Rehabil. 2011; 90(5 Suppl 1):S69-75. DOI: 10.1097/PHM.0b013e31820be160. View

Kang Y, Jang D, Jeon J, Lee S, Jeong S, Shin D . Pressure monitoring of multilayer inelastic bandaging and the effect of padding in breast cancer-related lymphedema patients. Am J Phys Med Rehabil. 2012; 91(9):768-73. DOI: 10.1097/PHM.0b013e3182643c36. View

Yamamoto T, Todo Y, Kaneuchi M, Handa Y, Watanabe K, Yamamoto R . Study of edema reduction patterns during the treatment phase of complex decongestive physiotherapy for extremity lymphedema. Lymphology. 2008; 41(2):80-6. View

10.

Ozaslan C, Kuru B . Lymphedema after treatment of breast cancer. Am J Surg. 2004; 187(1):69-72. DOI: 10.1016/j.amjsurg.2002.12.003. View

11.

Quirion E . Recognizing and treating upper extremity lymphedema in postmastectomy/lumpectomy patients: a guide for primary care providers. J Am Acad Nurse Pract. 2010; 22(9):450-9. DOI: 10.1111/j.1745-7599.2010.00542.x. View

12.

Lasinski B, McKillip Thrift K, Squire D, Austin M, Smith K, Wanchai A . A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011. PM R. 2012; 4(8):580-601. DOI: 10.1016/j.pmrj.2012.05.003. View

13.

Bergmann A, da Costa Leite Ferreira M, de Aguiar S, de Almeida Dias R, de Souza Abrahao K, Paltrinieri E . Physiotherapy in upper limb lymphedema after breast cancer treatment: a randomized study. Lymphology. 2014; 47(2):82-91. View

14.

Eyigor S, Cinar E, Caramat I, Unlu B . Factors influencing response to lymphedema treatment in patients with breast cancer-related lymphedema. Support Care Cancer. 2015; 23(9):2705-10. DOI: 10.1007/s00520-015-2633-9. View

15.

. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology. 2013; 46(1):1-11. View

16.

Deltombe T, Jamart J, Recloux S, LeGrand C, Vandenbroeck N, Theys S . Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema. Lymphology. 2007; 40(1):26-34. View

17.

Saito Y, Nakagami H, Kaneda Y, Morishita R . Lymphedema and therapeutic lymphangiogenesis. Biomed Res Int. 2013; 2013:804675. PMC: 3810055. DOI: 10.1155/2013/804675. View

18.

Koul R, Dufan T, Russell C, Guenther W, Nugent Z, Sun X . Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer. Int J Radiat Oncol Biol Phys. 2006; 67(3):841-6. DOI: 10.1016/j.ijrobp.2006.09.024. View

19.

Zimmermann A, Wozniewski M, Szklarska A, Lipowicz A, Szuba A . Efficacy of manual lymphatic drainage in preventing secondary lymphedema after breast cancer surgery. Lymphology. 2013; 45(3):103-12. View

20.

Helyer L, Varnic M, Le L, Leong W, McCready D . Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients. Breast J. 2009; 16(1):48-54. DOI: 10.1111/j.1524-4741.2009.00855.x. View