Dayes, I.S., Whelan, T.J., Julian, J.A., Parpia, S., Pritchard, K. I., D'Souza, D. P., . . . Levine, M.N. (2013). Randomized trial of decongestive lymphatic therapy for the treatment of lymphedema in women with breast cancer. Journal of Clinical Oncology, 31, 3758-3763.doi: 10.1200/JCO.2012.45.7192
To investigate the treatment of breast cancer–related lymphedema using massage-based manual lymphatic drainage (MLD) and bandaging and compression versus control using only compression garments
Women previously treated for breast cancer with a minimum 10% difference in volume between arms were randomly assigned to two groups. The control received only compression garments while the experimental group received MLD therapy and compression garments, and assessed for reduction in arm volume.
CDT with MLD appears to be more beneficial to patients with lymphedema for more than one year (experimental group), showing increased volume loss, compared to control of garments only. The reduction in excess arm volume for patients in the experimental group was 29% and 22.6% for the control group (p = .34).
No significant difference in group with lymphedema less than one year, suggesting this group may respond to less intensive treatment. More research is needed.
Lymphedema identified within the first year may require less intensive therapy. It is important for nurses to question patients with breast cancer about their affected extremity, and refer to a professional with specialized training in lymphedema management regarding risk reduction.