Abstract
BackgroundUpper-limb lymphedema (ULL) occurs in 15–20% of women after breast-cancer treatment. Its intensive therapy relies on complete (complex) decongestive physiotherapy (CDP), whose duration is not well-established. ObjectiveDetermine optimal intensive-phase CDP duration for lymphedema-volume reduction and factors predicting its success, with the hope of halving it from 11 to 4days. MethodsAll patients with ULL (08/2011–06/2012) after breast-cancer treatment referred to our Department of Lymphology in a rehabilitation facility for 11days of CDP were eligible. Lymphedema volume was calculated using the truncated-cone formula. Volume reduction considered clinically relevant after 4days was defined as ≥75% of the total reduction obtained after 11days. ResultsWe included 129 women (median age: 64 (range: 42–88) years). Mean (sd) lymphedema volume was 907 (558) ml at CDP onset, decreased to 712 (428) ml after 4days (vs. onset, P<.0001) and 606 (341) ml after 11days (vs. 4, P<.0001), corresponding to 33% total lymphedema-volume reduction. For all patients, 4days of CDP achieved 63% (sd 40%) of that total reduction, with ≥75% for 50 (39%) patients. Surgery-to-lymphedema-onset interval >2years was the only factor significantly associated with 4days achieving ≥75% of the total lymphedema-volume reduction. ConclusionIntensive phase CDP for 11days obtained significantly more volume reduction of breast cancer-related ULL than 4.
Published Version
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