Pilot study of oncological safety of extracorporeal shock wave therapy for post-mastectomy lymphedema in patients with breast cancer

Abstract

Studying the long-term results of extracorporeal shock wave therapy (ESWT) in patients with breast cancer (BC) to obtain preliminary data on the oncological safety of the method, necessary for planning further extensive studies. The pilot study included 18 women aged 45 to 70 years (mean age 55.6 years) with breast cancer of stages I-IIIA (stage I - in 4 cases, stage IIA - in 8 cases, stage IIIA - in 6 cases) and postmastectomy lymphedema. 11 (61%) patients received complex treatment, 7 (39%) patients received combined treatment. ESWT from the MasterPuls MP200 apparatus was performed with a radial shock wave on the axillary region on the side of the surgical operation using a dynamic technique: R-SW applicator with a standard D20-S nozzle, penetration depth 50 mm, pressure 2-2.5 bar, pulse frequency 8-10 Hz, 2000-4000 pulses each session, 1 time per week, 5 procedures in 1 course. After a course of ESWT, the average decrease in the volume of the edematous upper limb for the entire group of patients was 41.8±4.6% (p<0.05) with the effect maintained for 3 years. During 3 years of observation, none of the patients developed breast cancer progression - ESWT did not have a negative effect on the course of breast cancer and did not worsen oncological parameters. Obtained data can serve as a basis for well-organized cohort studies of the expediency of using shock wave therapy in oncology rehabilitation of patients.