Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema
TL;DR: The results of this study will provide information on the effectiveness of Manual Lymphatic Drainage and its impact on the quality of life and physical limitations of these patients, as well as the improvement of the concomitant symptomatology.
Abstract: Background
Lymphoedema is a common and troublesome condition that develops following breast cancer treatment. The aim of this study is to analyze the effectiveness of Manual Lymphatic Drainage in the treatment of postmastectomy lymphoedema in order to reduce the volume of lymphoedema and evaluate the improvement of the concomitant symptomatology.
Citations
More filters
31 May 2013
TL;DR: A complex exercise program was implemented over 4 weeks, 60 minutes per day, with 3 types of exercise for stimulation whereas the control group was performed a classical decongestive physiotherapy in a same day.
Abstract: The 14 middle-aged women involved voluntary in this study and then they were divided into two groups(n =7 per group). The complex exercise program was implemented over 4 weeks, 60 minutes per day, with 3 types of exercise for stimulation whereas the control group was performed a classical decongestive physiotherapy in a same day. For data analysis, the mean and standard deviation were estimated; 2 way repeated measures ANOVA was carried out.
10 citations
TL;DR: A first indication that reliability and validity of the Persian version of LLIS in patients with breast cancer induced lymphedema was good is suggested, which may be helpful in designing interventions to improve quality of life.
Abstract: Despite the high prevalence of lymphedema in Iranian breast cancer patients, there is no valid instrument for measuring quality of life in this population. The aim of this study was to assess reliability and validity of the Persian version of Lymphedema Life Impact Scale (LLIS) in breast cancer patients. Forward-backward procedure was applied to translate The LLIS from English into Persian. The LLIS is an 18-item measure of physical, psychosocial, and functional impairments caused by lymphedema. Experts and patients assessed content and face validity, respectively. Discriminant validity was evaluated by comparing breast cancer patients with and without lymphedema. Convergent validity was assessed by comparing LLIS score with SF-36 (functional component) and the EORTC-QLQ-C30 (functional component). The construct validity also was evaluated using confirmatory and exploratory factor analyses. Internal consistency was evaluated by Cronbach’s alpha coefficient. Stability was assessed by test-retest analysis over a one-week interval in 13 patients. In all 446 breast cancer patients were entered into the study. The content and face validity of Persian version of LLIS were acceptable and minor corrections were applied in final version. The questionnaire differentiated well in patients’ with and without lymphedema and lending support to its discriminant validity. Confirmatory factor analysis showed a good fit for the data. Cronbach’s alpha coefficient in physical, psychosocial and functional subscales were 0.873, 0.854 and 0.884 respectively. Intra-class correlation coefficient of total score of the LLIS was 0.96. The findings of this study suggest a first indication that reliability and validity of the Persian version of LLIS in patients with breast cancer induced lymphedema was good. Application of this instrument for identifying problems of patients with upper extremity lymphedema may be helpful in designing interventions to improve quality of life.
10 citations
Cites background from "Manual lymphatic drainage therapy i..."
...Lymphedema, a major complication of breast cancer and its treatment, can cause long-term physical and mental health consequences in patients [5]....
[...]
TL;DR: MLD is a gentle procedure that does not increase the risk of breast cancer recurrence in patients who develop BCRL, and receiving MLD therapy was not an outcome factor in multivariate analyses.
Abstract: Background This retrospective cohort study evaluated whether manual lymphatic drainage (MLD) therapy increases the risk of recurrence of breast cancer. Methods We analyzed 1,106 women who were diagnosed with stage 0-3 breast cancer between 2007 and 2011 and experienced remission after surgery and adjuvant therapy. The patients were divided into two groups: group A (n=996), in which patients did not participate in any MLD therapy, regardless of whether they developed breast cancer-related lymphedema (BCRL) after cancer treatment; and group B (n=110), in which patients participated in MLD therapy for BCRL. All patients were monitored until October 2013 to determine whether breast cancer recurrence developed, including local or regional recurrence and distant metastasis. Patients who developed cancer recurrence prior to MLD therapy were excluded from analysis. Risk factors associated with cancer recurrence were evaluated using Cox proportional hazards models. Results During the monitoring period, 166 patients (15.0%) developed cancer recurrence, including 154 (15.5%) in group A and 12 (10.9%) in group B. The median period from surgery to cancer recurrence was 1.85 (interquartile range 1.18-2.93) years. Independent risk factors for cancer recurrence were tumor histological grading of grade 3, high number (≥3) of axillary lymph node invasion, and a large tumor size (>5 cm). Factors protecting against recurrence were positive progesterone receptor status and receiving radiation therapy. Receiving MLD therapy was not an outcome factor in multivariate analyses (hazard ratio 0.71, 95% confidence interval 0.39-1.29, P=0.259). Conclusion MLD is a gentle procedure that does not increase the risk of breast cancer recurrence in patients who develop BCRL.
9 citations
TL;DR: This preliminary study indicated that MLD promoted increased brachial vein velocity flow in the short term, and there was a significant increase of blood flow velocity after the therapeutic procedure with upper limb elevation.
7 citations
Cites background or methods from "Manual lymphatic drainage therapy i..."
...The specific contribution of MLD to controlling lymphedema is as yet unproven, and there is no evidence of the permanence of the effect of MLD.(16,24) The relationship between the blood and lymphatic systems(25)...
[...]
...The best option is to reduce the edema, increase functionality, and decrease discomfort.23 The specific contribution of MLD to controlling lymphedema is as yet unproven, and there is no evidence of the permanence of the effect of MLD.16,24 The relationship between the blood and lymphatic systems25 allows the assessment of the circulatory effect of therapeutic treatment for evaluating the blood flow velocity, enabling even notice the duration, as the purpose of this study....
[...]
...Lymphedema treatment with the named complex physical therapy, which involves MLD and compression bandaging, is controversial because interpretation of the results is limited by the different methodologies used, which does not allow the evaluation of the isolated contribution of MLD to circulatory flow and therefore to the control of edema.(15,16)...
[...]
17 Jun 2015
TL;DR: Sera necesario inculcarles a estas pacientes con riesgo potencial de padecer un linfedema secundario de la extremidad superior, unas normas de higiene de vida y educacion sanitaria, para prevenir en lo posible su aparicion.
Abstract: El cancer constituye un problema importante de salud publica. El cancer de mama es la neoplasia mas frecuente del sexo femenino. En Europa se estima que 1/11 mujeres a lo largo de su vida desarrollaran esta enfermedad. El linfedema de extremidad superior, producido por los tratamientos del cancer de mama tales como cirugia o radioterapia, suele cursar con un aumento de volumen que interfiere con la funcionalidad de la extremidad. Sera necesario inculcarles a estas pacientes con riesgo potencial de padecer un linfedema secundario de la extremidad superior, unas normas de higiene de vida y educacion sanitaria, para prevenir en lo posible su aparicion. Una vez instaurado, un tratamiento de fisioterapia lo mas precoz posible sera importante para mejorar la calidad de vida de estas pacientes. El drenaje linfatico manual es la tecnica de mayor eficacia que aumenta cuando se combina con otras como los ejercicios, presoterapia o vendaje compresivo.
6 citations
References
More filters
TL;DR: Chronic oedema arising for reasons other than cancer treatment is much more prevalent than generally perceived, yet resources for treatment are mainly cancer-based, leading to inequalities of care.
Abstract: Summary Background: Lymphoedema/chronic oedema is an important cause of morbidity in the population, but little is known of its epidemiology and impact on patients or health services. Aim: To determine the magnitude of the problem of chronic oedema in the community, and the likely impact of oedema on use of health resources, employment and patient’s quality of life.
499 citations
"Manual lymphatic drainage therapy i..." refers background in this paper
...Problems associated with lymphoedema include: pain, altered sensations such as discomfort and heaviness, difficulties with physical mobility, physiological distress, recurrent infections and social isolation [3,4]....
[...]
TL;DR: Treatment for breast cancer is associated with considerable arm morbidity, which has a negative impact on QOL, andArm morbidity should be carefully monitored in future studies involving local treatment modalities for Breast cancer.
Abstract: PURPOSE: To determine the prevalence of and contributing factors for chronic arm morbidity including lymphedema in breast cancer patients after treatment and to assess the impact of arm morbidity on quality of life (QOL). PATIENTS AND METHODS: A four-question screening questionnaire was developed and mailed to a random sample of 744 breast cancer patients treated curatively in two cancer centers from 1993 to 1997. Patients were without recurrence and at least 2 years from diagnosis. Respondents were classified as with or without arm-related symptoms on the basis of the survey. Stratified random samples from each group were then invited for a detailed assessment of their symptoms and signs, including the presence of lymphedema. Their QOL was assessed by the European Organization for Research and Treatment of Cancer QOL Questionnaire C-30 and by a detailed arm problem questionnaire that assessed various aspects of daily arm functioning. RESULTS: Approximately half of all screened patients were symptomatic a...
344 citations
"Manual lymphatic drainage therapy i..." refers background in this paper
...In a study in which 744 patients with breast cancer were assessed with these quality of life scales, some imbalances regarding the quality of life in those patients with lymphoedema were found [ 8 ]....
[...]
TL;DR: HRQOL was lower for BrCa survivors with diagnosed lymphedema and for those with arm symptoms without diagnosed lyMPhedema in the IWHS, according to a dose-response relation between number of arm symptoms and lower HRQOL.
Abstract: Purpose The impact of lymphedema or related arm symptoms on health-related quality of life (HRQOL) in breast cancer (BrCa) survivors has not been examined using a large population-based cohort. Patients and Methods The Iowa Women’s Health Study (IWHS) collected self-report data for lymphedema, arm symptoms, and HRQOL (Medical Outcomes Study Short Form-36) in 2004 and data for cancer diagnosis, treatment, and behavioral and health characteristics between 1986 and 2003. We studied 1,287 women, age 55 to 69 years at baseline, who developed unilateral BrCa. We used cross-sectional analyses to describe the prevalence of lymphedema and arm symptoms and multivariate-adjusted generalized linear models to compare HRQOL (physical functioning, bodily pain, general health, physical and emotional role limitations, vitality, social functioning, and mental health) between the following three survivor groups: women with lymphedema (n 104), women with arm symptoms without diagnosed lymphedema (n 475), and women without lymphedema or arm symptoms (n 708).
343 citations
TL;DR: It is suggested that CB on its own should be considered as a primary treatment option in reducing arm lymphedema volume, as well as manual lymph drainage massage in combination with multi-layered compression bandaging.
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.
235 citations
"Manual lymphatic drainage therapy i..." refers background in this paper
...On the other hand, the fact that CPT implies several techniques (manual lymph drainage, skin care and multilayer compression bandaging followed by a compression garment to reduce oedema and therapeutic exercises) makes it difficult to recognize which of them is the truly effective one in the treatment of lymphoedema [ 12-14 ]....
[...]
TL;DR: The study showed that both groups obtained a significant reduction in edema and that MLD did not contribute significantly to reduce edema volume.
Abstract: A prospective randomized study was carried out to investigate whether the addition of manual lymphatic drainage (MLD) to the standard therapy could improve treatment outcome in women with lymphedema of the ipsilateral arm after breast cancer treatment. Forty-two patients were randomly assigned to receive standard therapy or standard therapy plus MLD 8 times in 2 weeks and training in self-massage. The standard therapy consisted of use of a compression garment, exercises and information about lymphedema and skin care. The efficacy of treatment was evaluated by reduction in lymphedema volume during treatment and by improvement in symptoms potentially related to lymphedema. The patients were followed-up for a total of 12 months. The study showed that both groups obtained a significant reduction in edema and that MLD did not contribute significantly to reduce edema volume.
220 citations