Effectiveness of complex decongestive therapy in management of breast cancer associated lymphedema

Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with unilateral arm lymphedema after breast cancer ALND were enrolled.The patients were divided into three groups based on the difference of circumference between the affected and unaffected extremity:group 1,mild lymphedema in circumference difference;group 2,moderate lymphedema,and group 3,severe lymphedema.These patients received four weeks of CDT and self-administered home therapy.Arm circumference was measured before,right after CDT,3 months and 12 months of follow-up.Results:In the first group,the circumference difference was 1.53±0.73 cm prior to CDT,and 0.32±0.59 cm right after CDT,and the difference was statistically significant(P<0.001).At the 1-year-follow-up,we got an even higher value than the pre-CDT one,however,there was no significant difference(P=0.175).At the end of CDT,the circumference difference of the third group was 4.52±2.58 cm,significantly lower than the baseline level(8.76±3.07 cm)(P<0.001).In the third group,the reduction of circumference difference was persisted for 12 months.Conclusion:The effects of CDT were maintained for 12 months,while there were differences in progress of circumference difference among the three groups.The effects of patients with severe initial edema(>5 cm increased)last longer.

Management of lymphedema is really a matter in patients with breast cancer

Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in patients with breast cancer.Diagnosis relies on clinical evaluation and objective measures,including arm circumference and volumetric assessments,along with lymphoscintigraphy and ultrasonic measurements.Treatment primarily involves complex decongestive physical therapy,comprising manual lymphatic drainage,compression therapy,exercise,and meticulous skin care.These interventions aim to reduce swelling,alleviate discomfort,and prevent further complications.Additionally,lifestyle modifications such as avoiding extreme temperatures and maintaining proper hygiene are essential.Flavonoids can be used for drug therapy.Despite its prevalence,lymphedema often receives inadequate attention in clinical practice,emphasizing the importance of raising awareness and enhancing medical services for affected individuals.Clinicians play a pivotal role in educating patients about preventive measures and ensuring timely intervention.Overall,a comprehensive approach encompassing early diagnosis,multidisciplinary management,and patient education is essential to mitigate the burden of lymphedema in patients with breast cancer and improve their overall well-being.

Lymphovenous anastomosis and complex decongestive therapy for severe deformed lymphedema with recurrent infection:A case report

BACKGROUND Lower extremity lymphedema is a common complication following treatment for gynecological malignancies.Its incidence rate can reach up to 70%,affecting~20 million people worldwide.However,specialized treatment centers are scarce,and there is a lack of consensus on treatment approaches.Furthermore,there are even fewer reports on the systematic and effective treatment of severe lymphedema with malformations.Effective management of this condition remains a significant challenge for clinicians.CASE SUMMARY A 40-year-old woman developed bilateral leg swelling 6 years after receiving treatment for endometrial cancer.Since August 2018,she experienced>30 episodes of lymphangitis.Upon presentation,she exhibited bilateral leg swelling and deformation,with four large swellings in the posterior thigh that impeded movement,and pain in the limbs.Skin manifestations included lichenoid lesions and features of deep sclerosis.Radionuclide lymphoscintigraphy confirmed the diagnosis of lower limb lymphedema.After 6 mo of complex decongestive therapy(CDT)and three lymphaticovenous anastomosis(LVA)treatments,the patient lost 49 kg in weight.She also experienced a maximum circumference reduction of 35.2 cm in the left lower limb and 37.5 cm in the right lower limb.The leg pain disappeared,her swelling significantly decreased,and she regained the ability to walk,cycle,and run normally.CONCLUSION The combined application of CDT and LVA therapy demonstrates significant positive effects in the treatment of severe,deformed stage III lymphedema.

Study on the correlation between bandage bandage and pressure therapy of lymphedema

To explore the effects of bandage technology and pressure therapy in breast cancer with lymphedema.Methods A total of 91 patients,with breast cancer-related lymphedema and hospitalized in a third-class hospital in Jiangsu Province from May to December,2018,were selected and sequenced in class“ABC”in the order of entry.The patients in class“A”were enrolled in“8”shaped bandaging group.The patients in class“B”were enrolled in“5”spiral bandaging group.The patients in class“C”were enrolled in combined bandage group.The primary outcome was the degree of limb swelling used by multiple-frequency bioelectrical impedance analysis.Secondary outcomes were the amount of bandage losses,counting 24-hour bandage loose occurrences and patients satisfaction.All outcomes were evaluated both before and after treatment.Results After treatment,there was a significant difference in the regression of limb swelling in all three groups(P<0.05).However,the largest amplitude of regression was observed in combined bandage group(limb circumference ratio:53%and tissue water ratio:68%).Although“8”bandaging group had large material,bandage cost and minimum comfort,the bandage has good stability and no case of 24-hour bandage loose occurrences was found in this group.The“5”partial binding group had an advantage in the amount of bandage losses and comfort level,but among which 3 patients had the phenomenon of loose bandage at the joint.The combined bandage group had the best therapeutic effect in limb swelling and patients satisfaction(P<0.05).Conclusion The combined bandage group significantly decreased the degree of limb swelling and 24-hour bandage loose occurrences.Importantly,this treatment improved the degree of patients’satisfaction.The treatment of“8”shaped bandaging combined with spiral bandaging is worthy of clinical promotion.