Factors influencing efficacy of complete decongestive treatment in patients with breast cancer-linked arm lymphoedema

Dragana Bojinović-Rodić,Tamara Popović,Tatjana Nožica-Radulović,Samra Pjanić

doi:10.5937/scriptamed52-30638

Abstract

Background/Aim: The most recommended form of lymphoedema therapy is complete decongestive treatment (CDT). Efficacy of CDT in patients with arm lymphoedema related to malignant breast tumour has reported in many studies, but the predictive factors of outcome of this therapy have not been yet sufficiently investigated. The purpose of this research was to identify predictive factors of efficacy of CDT in patients with breast cancer-linked arm lymphoedema throughout the intensive phase of therapy. Methods: The prospective study included 51 patients with breast cancer-linked arm lymphoedema who were subjected to a 3-week program of CDT. Patients' clinical and demographic features, breast cancer treatment characteristics, lymphoedema and CDT characteristics were collected and assessed for their prognostic value. The influence of certain predictors on the degree of lymphoedema reduction was evaluated by multivariate linear regression analysis. Results: Mean age was 58.1 ± 8.0 (95 % CI: 55.8 - 60.3), median of BMI was 28.4 kg/m2 (95 % CI: 27.2 - 29.6). The average duration of lymphoedema was 36.5 ± 43.9 months (95 % CI: 24.1 - 48.8). The mean size of lymphoedema before CDT was 6.99 ± 5.36 %, and the mean degree of lymphoedema reduction was 63.7 ± 28.6 %. The mean compliance to bandages was 217.5 ± 97.8 hours (95 % CI: 190.0 - 245.0) and 7 (13.7 %) patients had a history of erysipelas of the ipsilateral arm. When observing each individual predictor, statistically most significant contribution showed the size of lymphoedema before the therapy (p < 0.001), then history of erysipelas (p < 0.01), and patients' age (p < 0.05). Conclusion: Size of lymphoedema before treatment is the most crucial prognostic factor of the efficacy of CDT in the patients with breast cancer-linked arm lymphoedema. The present study also identified history of erysipelas and patients age as independent predictors of the CDT efficacy.

Highlights

Breast cancer-linked arm lymphoedema is ab-normal accumulation of interstitial fluid due to mechanical failure of the lymphatic system of the upper limb, usually because of the breast cancer surgery, radiotherapy, infection, or trauma
The average incidence of breast cancer-linked arm lymphoedema caused by axillary dissection is greater than 20 %, and
The size of lymphoedema before therapy was sta-tistically significantly negatively correlated with degree of lymphoedema reduction (p < 0.001)

Summary

Introduction

Breast cancer-linked arm lymphoedema is ab-normal accumulation of interstitial fluid due to mechanical failure of the lymphatic system of the upper limb, usually because of the breast cancer surgery, radiotherapy, infection, or trauma. The average incidence of breast cancer-linked arm lymphoedema caused by axillary dissection is greater than 20 %, and. This article should be cited as follows: Bojinović-Rodić D, Pjanić S, Popović T, Nožica-Radulović T. Factors influencing efficacy of complete decongestive treatment in patients with breast cancer-linked arm lymphoedema. Scr Med 2021 Jun;52(2):[132-7]. Bojinović-Rodić et al Scr Med 2021 Jun;52(2):[132-7]. The overall goal of lymphoedema treat-ment is to reduce swelling, mobilise congestive interstitial fluid, reduce connective and fat tissue proliferation, control symptoms, and minimise the consequences.[5] After sentinel lymph node biopsy is less than 10 %.1-4 The overall goal of lymphoedema treat-ment is to reduce swelling, mobilise congestive interstitial fluid, reduce connective and fat tissue proliferation, control symptoms, and minimise the consequences.[5]

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