Abstract
Secondary lymphedema of the arm (SLEA) is the most common consequence of operation and/or radiotherapy for the malignant tumors of the breast. The frequency of SLEA is from 6 to 30 percent in patients with breast cancer This paper presents literature data about the methods of physical treatment of SLEA. A complex of decongestive physical therapy (CDP) is described consisting of the skin care of the arm on the operated and/or irradiated side, kinesy therapy, manual lymphodrainage of arm, and ban- daging with multilayer non elastic bandages of the arm. Along with CDP, a device assisted sequential pneumatic compression can be applied in order to reduce the SLEA. The prevention and early detection of SLEA, while it is still reversible, is the most important task in the postoperative and postirradiation period after the treatment of breast cancer.
Highlights
Secondary lymphedema of the arm (SLEA) arises due to overloading of the lymphatic vessels, i.e. disproportion between volume of the lymph and transportation capacity of the lymphatics [1]
Different data from the literature appear on the frequency of SLEA due to non-standardized criteria for diagnostic assessment of SLEA, different times of appearance, and neglectfulness of the problem of SLEA as compared to the primary disease
In a study summarizing data on 35 papers from different parts of the world, the frequency of SLEA ranged from 6% to 30% of treated breast cancer patients [1,2]
Summary
Secondary lymphedema of the arm (SLEA) arises due to overloading of the lymphatic vessels, i.e. disproportion between volume of the lymph and transportation capacity of the lymphatics [1]. In a study summarizing data on 35 papers from different parts of the world, the frequency of SLEA ranged from 6% to 30% of treated breast cancer patients [1,2]. SLEA does not represent only an esthetic problem. It is often followed by a feeling of a weight in the arm, pain, numb sensation and functional disorder ("separation" of the shoulder, contracture of the shoulder, paresis and/or paralysis of the brachial plexus) [1,6]. The simplest and most used method is the measurement of the circumference of both arms. Volumetric method of measurement, which measures the volume of primed liquid of the submerged arm (minimal fluid quantity should be 200 ml), and more sophisticated methods like PET, MRI and CT are rarely used
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