Hwang, J.M., Hwang, J.H., Kim, T.W., Lee, S.Y., Chang, H.J., & Chu, I.H. (2013). Long-term effects of complex decongestive therapy in breast cancer patients with arm lymphedema after axillary dissection. Annals of Rehabilitation Medicine, 37, 690–697. 

To investigate complex decongestive therapy (CDT) and its long-term effects on reduction of edema in patients with breast cancer-related lymphedema who have undergone axillary lymph node dissection, based on their initial fluid volume

A retrospective review of 57 patients was done. Patients were treated with CDT for two weeks and followed for 24 months, with arm volumes being measured before/immediately after CDT, and at 3, 6, 12, and 24 months. Patients were divided into two groups according to their percent excess volume (PEV).

• N = 57  
• AGE = 48.6 (SD = 10.3)
• MALES: 2%, FEMALES: 98%
• KEY DISEASE CHARACTERISTICS: Breast cancer-related lymphedema
• OTHER KEY SAMPLE CHARACTERISTICS: Right-arm lymphedema in 23 patients; left-arm lymphedema in 34 patients.

LOCATION: Seoul, Korea

• Retrospective review of patients

• Independent T-test,
• Linear mixed model 
• SPSS^®, version 18.0

Group 1 had a mean PEV of 11.4% (SD = 5) before CDT and 14.1% (SD = 10.6) at 24 months after CDT, with no significant difference. Group 2, which had a higher initial PEV of 41.9% (SD = 19.6) showed a significant reduction at 24 months to 28.8% (SD = 15.7).

Patients with a higher initial PEV showed a greater reduction in fluid volume after using CDT. For patients with a lower initial PEV, their lymphedema did not increase in severity.

• Small sample (< 100)

Nurses should encourage movement of affected arms to promote lymphatic drainage, especially in patients with a higher PEV.