Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2016

Open Access 01-12-2016 | Research article

Effect of complete decongestive therapy and home program on health- related quality of life in post mastectomy lymphedema patients

Authors: Ganeswara Rao Melam, Syamala Buragadda, Adel A. Alhusaini, Nisha Arora

Published in: BMC Women's Health | Issue 1/2016

Login to get access

Abstract

Background

Secondary lymphedema is common in women treated for breast cancer. It may be a result of surgery or radiotherapy. Edema commonly affects the arm, leading to discomfort, reduced arm movements, pain and diminished quality of life. Therefore, the relationship between post mastectomy lymphedema and quality of life has evolved as an important criteria in treatment of breast cancer survivors.

Methods

Sixty breast cancer survivors who developed post mastectomy lymphedema were recruited. Patients were divided into 2 groups (n = 30) according to the treatment they received; Conventional therapy (CT) and Complete Decongestive Therapy (CDT) groups. Measurements were taken at baseline, 4 and 6 weeks. Health related Quality of Life was evaluated with the EORTC QLQ C30 and EORTC QLQ-BR23 questionnaires. Pain was measured using the Visual Analogue Scale. Descriptive statistics were used to analyze participant demographics and repeated measures of ANOVA was used for within and between group comparisons.

Results

Both groups showed improved quality of life and diminished pain after 6 weeks of treatment. However, greater improvement was observed in CDT group compared to the CT group.

Conclusion

In this study, remedial exercises and home program in addition to manual lymphatic drainage and compression bandaging resulted in improved quality of life. Early identification of lymphedema and incorporation of remedial exercises and a home program improve the quality of life for breast cancer survivors.

Trial registration

Trial registry ID: ISRCTN13242080, Date of registration: 7 April 2016
Literature
1.
Alawadi SA, Ohaeri JU. Health - related quality of life of Kuwaiti women with breast cancer: a comparative study using the EORTC Quality of Life Questionnaire. BMC Cancer. 2009;9:222.CrossRefPubMedPubMedCentral
2.
Ahmed RL, Prizment A, Lazovich D, Schmitz KH, Folsom AR. Lymphedema and quality of life in breast cancer survivors: the Iowa Women’s Health Study. J Clin Oncol. 2008;26:5689–96.CrossRefPubMedPubMedCentral
3.
Mak SS, Mo KF, Suen JJ, Chan SL, Ma WL, Yeo W. Lymphedema and quality of life in Chinese women after treatment for breast cancer. Eur J Oncol Nurs. 2009;13:110–5.CrossRefPubMed
4.
Voogd AC, Ververs JM, Vingerhoets AJ, Roumen RM, Coebergh JW, Crommelin MA. Lymphedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Br J Surg. 2003;90:76–81.CrossRefPubMed
5.
Hagrass SAA, Allah ESA, Hassan SAA, Sawy WHE. Improving quality of life for women with arm lymphedema post mastectomy in Zagazig City. Aust J Basic Appl Sci. 2012;6:428–42.
6.
Lee SH, Min YS, Park HY, Jung TD. Health-related quality of life in breast cancer patients with lymphedema who survived more than one year after surgery. J Breast Cancer. 2012;15:449–53.CrossRefPubMedPubMedCentral
7.
Chen CM, Cano SJ, Klassen AF, King T, McCarthy C, Cordeiro PG, Morrow M, Pusic AL. Measuring quality of life in oncologic breast surgery: a systematic review of patient-reported outcome measures. Breast J. 2010;16:587–97.CrossRefPubMed
8.
Yuste Sánchez MJ, Lacomba MT, Sánchez BS, Merino DP, da Costa SP, Tellez EC, Zapico Goni Á. Health related quality of life improvement in breast cancer patients: Secondary outcome from a simple blinded, randomized clinical trial. Breast. 2015;24:75–81.CrossRefPubMed
9.
Velloso FS, Barra AA, Dias RC. Functional performance of upper limb and quality of life after sentinel lymph node biopsy of breast cancer. Rev Bras Fisioter. 2001;15:146–53.CrossRef
10.
da Silva RC M, Rezende LF. Assessment of impact of late postoperative physical functional disabilities on quality of life in breast cancer survivors. Tumor. 2014;100:87–90.
11.
Kootstra J, Hoekstra-Weebers JEHM, Rietman H, de Vries J, Baas P, Geertzen JHB, et al. Quality of life after sentinel lymph node biopsy or axillary lymph node dissection in stage I/II breast cancer patients: a prospective longitudinal study. Ann Surg Oncol. 2008;15:2533–41.CrossRefPubMedPubMedCentral
12.
Gautam AP, Maiya AG, Vidyasagar MS. Effect of home-based exercise program on lymphedema and quality of life in female post mastectomy patients: pre-post intervention study. J Rehabil Res Dev. 2011;48:1261–8.CrossRefPubMed
13.
Ha K, Choi S. The effect of a PNF technique program after mastectomy on lymphedema patients’ depression and anxiety. J Phys Ther Sci. 2014;26:1065–7.CrossRefPubMedPubMedCentral
14.
Passik SD, McDonald MV. Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer. 1998;83 suppl 12:2817–20.CrossRefPubMed
15.
Pyszel A, Malyszczak K, Pyszel K, Andrzejak R, Szuba A. Disability, psychological distress and quality of life in breast cancer survivors with arm lymphedema. Lymphology. 2006;39:185–92.PubMed
16.
Pusic AL, Cemal Y, Albornoz C, Klassen A, Cano S, Sulimanoff I, Hernandez M, Massey M, Cordeiro P, Morrow M, Mehrara B. Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes. J Cancer Surviv. 2013;7:83–92.CrossRefPubMed
17.
Poage E, Singer M, Armer J, Poundall M, Shellabarger MJ. Demystifying lymphedema: development of the lymphedema putting evidence into practice card. Clin J Oncol Nurs. 2008;12:951–64.CrossRefPubMed
18.
Foldi M, Foldi E, Kubik S, editors. Textbook of Lymphology: for Physicians and Lymphedema Therapists. San Francisco: Urban & Fischer; 2006.
19.
Wittlinger H, Wittlinger G. Introduction to Dr Vodder’s Manual Lymph Drainage, Vol. 1: Basic Course. 4th ed. Heidelberg: Haug Publishers; 1992.
20.
Williams AF, Vadgama A, Franks PJ, Mortimer PS. A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care. 2002;11:254–61.CrossRef
21.
Tribe K. Treatment of lymphedema: the central importance of manual lymph drainage. Physiotherapy. 1995;83:154–6.CrossRef
22.
Bulley C, Gaal S, Coutts F, Blyth C, Jack W, Chetty U, Barber M, Tan CW. Comparison of breast cancer-related lymphedema (upper limb swelling) prevalence estimated using objective and subjective criteria and relationship with quality of life. Biomed Res Int. 2013;2013:807569.CrossRefPubMedPubMedCentral
23.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Nat Cancer Inst. 1993;85:365–76.CrossRefPubMed
24.
Hartl K, Engel J, Herschbach P, Reinecker H, Sommer H, Friese K. Personality traits and psychosocial stress: quality of life over 2 years following breast cancer diagnosis and psychological impact factors. Psychooncology. 2010;19:160–9.CrossRefPubMed
25.
Klee M, Grønvold M, Machin D. Quality of life of Danish women: population-based norms for the EORTC QLQ-C30. Qual Life Res. 1997;6:10.CrossRef
26.
Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27:32.CrossRefPubMedPubMedCentral
27.
Michels FA, Latorre Mdo R, Maciel MS. Validity, reliability and understanding of the EORTC-C30 and EORTC-BR23, quality of life questionnaires specific for breast cancer. Rev Bras Epidemiol. 2013;16:352–63.CrossRefPubMed
28.
Demirci S, Eser E, Ozsaran Z, Tankisi D, Aras AB, Ozaydemir G, Anacak Y. Validation of the Turkish versions of EORTC QLQ-C30 and BR23 modules in breast cancer patients. Asian Pac J Cancer Prev. 2011;12:1283–7.PubMed
29.
Hopwood P, Haviland J, Mills J, Sumo G, Bliss J M, START Trial Management Group. The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial). Breast. 2007;16:241–51.CrossRefPubMed
30.
Ha EH, Cho YK. The mediating effects of self-esteem and optimism on the relationship between quality of life and depressive symptoms of breast cancer patients. Psychiatry Investig. 2014;11:437–45.CrossRefPubMedPubMedCentral
31.
Kim MK, Kim T, Moon HG, Jin US, Kim K, Kim J, Lee JW, Kim J, Lee E, Yoo TK, Noh DY, Minn KW, Han W. Effect of cosmetic outcome on quality of life after breast cancer surgery. Eur J Surg Oncol. 2014;19:S0748–7983. (14)01287-6.
32.
El Fakir S, Abda N, Bendahhou K, Zidouh A, Bennani M, Errihani H, Benider A, Bekkali R, Nejjari C. The European organization for research and treatment of cancer quality of life questionnaire-BR 23 breast cancer-specific quality of life questionnaire: psychometric properties in a Moroccan sample of breast cancer patients. BMC Res Notes. 2014;7:53.CrossRefPubMedPubMedCentral
33.
Manandhar S, Shrestha DS, Taechaboonsermsk P, Siri S, Suparp J. Quality of life among breast cancer patients undergoing treatment in national cancer centers in Nepal. Asian Pac J Cancer Prev. 2014;15:9753–7.CrossRefPubMed
34.
Damodar G, Smitha T, Gopinath S, Vijayakumar S, Rao YA. Assessment of quality of life in breast cancer patients at a tertiary care hospital. Arch Pharm Pract. 2013;4:15.CrossRef
35.
Lee EH, Chun M, Kang S, Lee HJ. Validation of the Functional Assessment of Cancer Therapy-General (FACT-G) scale for measuring the health-related quality of life in Korean women with breast cancer. Jpn J Clin Oncol. 2004;34:393–9.CrossRefPubMed
36.
Beaulac SM, McNair LA, Scott TE, LaMorte WW, Kavanah MT. Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg. 2002;137:1253–7.CrossRefPubMed
37.
Webster K, Cella D, Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes. 2003;1:79.CrossRefPubMedPubMedCentral
38.
Koukouli S, Stamou A, Alegakis A, Georgoulias V, Samonis G. Psychometric properties of the QLQ-C30 (version 3.0) in a sample of ambulatory Cretan cancer patients. Eur J Cancer Care (Engl). 2009;18:447–56.CrossRef
39.
Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, Haji-Mahmoodi M. The EORTC breast cancer-specific quality of life questionnaire (EORTC QLQ-BR23): translation and validation study of the Iranian version. Qual Life Res. 2000;9:177–84.CrossRefPubMed
40.
Kim SJ, Yi CH, Kwon OY. Effect of complex decongestive therapy on edema and the quality of life in breast cancer patients with unilateral lymphedema. Lymphology. 2007;40:143–51.PubMed
41.
Morgan PA, Franks PJ, Moffatt CJ. Health related quality of life with lymphedema: a review of the literature. Int Wound J. 2005;2:47–62.CrossRefPubMed
42.
Karadibak D, Yavuzsen T, Saydam S. Prospective trial of intensive decongestive physiotherapy for upper extremity lymphedema. J Surg Oncol. 2008;97:572–7.CrossRefPubMed
43.
Kim SJ. The long term effects of complex decongestive physical therapy on lower extremity secondary lymphoedema and quality of life. J Phys Ther Sci. 2011;23:155–9.CrossRef
44.
Hwang JM, Hwang JH, Kim TW, Lee SY, Chang HJ, Chu IH. Long-term effects of complex decongestive therapy in breast cancer patients with arm lymphedema after axillary dissection. Ann Rehabil Med. 2013;37:690–7.CrossRefPubMedPubMedCentral
45.
Andersen L, Hojris I, Erlandsen M, Andersen J. Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage--a randomized study. Acta Oncol. 2000;39:399–405.CrossRefPubMed
46.
Devoogdt N, Christiaens MR, Geraerts I, Truijen S, Smeets A, Leunen K, Neven P, Van Kampen M. Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphedema related to breast cancer: randomized controlled trial. BMJ. 2011;343:d5326.CrossRefPubMedPubMedCentral
47.
Johansson K, Lie E, Ekdahl C, Lindfeldt J. A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Lymphology. 1998;31:56–64.PubMed
48.
Johansson K, Albertsson M, Ingvar C, Ekdahl C. Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema. Lymphology. 1999;32:103–10.PubMed
49.
McNeely ML, Magee DJ, Lees AW, Bagnall KM, Haykowsky M, Hanson J. The addition of manual lymph drainage to compression therapy for breast cancer related lymphedema: a randomized controlled trial. Breast Cancer Res Treat. 2004;86:95–106.CrossRefPubMed
50.
Sitzia J, Sobrido L, Harlow W. Manual lymphatic drainage compared with simple lymphatic drainage in the treatment of post-mastectomy lymphedema. Physiotherapy. 2002;88:99–107.CrossRef
51.
Szolnoky G, Lakatos B, Keskeny T, Varga E, Varga M, Dobozy A, Kemény L. Intermittent pneumatic compression acts synergistically with manual lymphatic drainage in complex decongestive physiotherapy for breast cancer treatment-related lymphedema. Lymphology. 2009;42:188–94.PubMed
52.
Badger C, Preston N, Seers K, Mortimer P. Physical therapies for reducing and controlling lymphedema of the limbs. Cochrane Database Syst Rev. 2004;18:CD003141.
53.
Mc Callin M, Johnston J, Bassett S. How effective are physiotherapy techniques to treat established secondary lymphedema following surgery for cancer? A critical analysis of the literature. N Z J Physiother. 2005;33:101–12.
54.
Meneses KD, McNees MP. Upper extremity lymphedema after treatment for breast cancer: a review of the literature. Ostomy Wound Manage. 2007;53:16–29.PubMed
55.
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;41:80–6.PubMed
56.
Martin ML, Hernandez MA, Avendano C, Rodríguez Fand Martinez H. Manual lymphatic drainage therapy in patients with breast cancer related lymphedema. BMC Cancer. 2011;11:94.CrossRefPubMedPubMedCentral
Metadata
Title
Effect of complete decongestive therapy and home program on health- related quality of life in post mastectomy lymphedema patients
Authors
Ganeswara Rao Melam
Syamala Buragadda
Adel A. Alhusaini
Nisha Arora
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2016
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-016-0303-9

Other articles of this Issue 1/2016

BMC Women's Health 1/2016 Go to the issue

Research article

Menstrual pattern among adolescent girls of Pokhara Valley: a cross sectional study

Research article

A descriptive study of female suicide deaths from 2005 to 2011 in Van city, Turkey

Research article

Knowledge of obstetric danger signs and associated factors among pregnant women in Erer district, Somali region, Ethiopia

Research article

“It is challenging… oh, nobody likes it!”: a qualitative study exploring Mozambican adolescents and young adults’ experiences with contraception

Case report

Recto-vaginal septum cystadenocarcinoma: a case report and review of the literature

Debate

Italian law on medically assisted reproduction: do women’s autonomy and health matter?