How is lymphedema prevented following breast cancer surgery?

Updated: Mar 24, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Results from a randomized, single-blind, controlled trial suggested that in trying to prevent arm lymphedema, manual lymph drainage with instructional guidelines and an exercise program does not provide significantly better results than an exercise program and guidelines alone do after axillary lymph node dissection for breast cancer. According to the investigators, triple therapy (manual drainage, guidelines, exercise) was not likely to produce medium to large effects in the short-term. [34, 87]

In contrast, however, a randomized, single-blind, clinical trial by Torres et al indicated that in women who have undergone breast cancer surgery, early physiotherapy may help to prevent postoperative secondary lymphedema for at least 1 year. The study included 116 women (patients who did or did not receive early physiotherapy) who had undergone breast cancer surgery involving dissection of the ancillary lymph nodes.

In the early physiotherapy group, treatment included manual lymph drainage, scar tissue massage, and progressive active and action-assisted shoulder exercises. At 1-year follow-up, the authors found that 25% of patients (14 patients) in the control group had developed secondary lymphedema, compared with 7% of patients (4 patients) in the early physiotherapy group. [88, 89]

One study has suggested that some patients have a genetic predisposition to develop lymphedema after breast cancer treatment. [90, 91] Other risk factors identified in this study were advanced cancer at the time of diagnosis, increased number of lymph nodes removed, and high body mass index.

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