The evaluation of selected physiotherapeutic methods in the treatment of post-mastectomy lymphoedema

Abstract

Abstract Introduction: Breast cancer constitutes 10.9% of all new cases of tumours registered in the Polish National Cancer Registry. Post-mastectomy lymphoedema of the upper limb is the most common post-operative complication. The aim of the study was to evaluate the effectiveness of selected physiotherapeutic methods in the treatment of post-mastectomy lymphoedema. Material and methods: The study included 90 post-mastectomy patients in Stalowa Wola, Zamość and Tyczyn in the period from January 2014 to July 2016. The patients participated in two-week outpatient physiotherapy. In order to assess the effectiveness of lymphoedema treatment, circumferences of upper extremities were measured before and after physiotherapy. The results were then statistically analysed. Results: The majority of the subjects had undergone mastectomy within a period shorter than 5 years before. It was noted that the post-mastectomy upper limb had a significantly smaller circumference after physiotherapy than before physiotherapy (p<0.001). The study revealed no differences in the measurements of arm circumference with regard to the time since the mastectomy was performed. According to the patients, manual lymphatic drainage was the most effective type of physiotherapy treatment (p=0.04). Statistical analysis revealed significantly smaller arm circumferences after physiotherapy than before physiotherapy in patients treated 2-3 times (p=0.001) compared to patients who underwent either fewer or more treatments at the same time. Conclusions: 1. Two-week physiotherapy treatment proved to be the most effective in reducing lymphoedema in the arm area. 2. The period since the performance of the mastectomy had no impact on the effectiveness of lymphoedema treatment. 3. According to the post-mastectomy patients, manual lymphatic drainage was the most effective type of lymphoedema treatment. 4. Applying 2-3 physiotherapeutic procedures at the same time showed the best results.