title: Lymphedema therapy reduces the volume of edema and pain in patients with breast cancer.
abstract: BACKGROUND
  Despite recent advances in breast-conserving surgery, upper-extremity lymphedema remains a problem for patients after the treatment of breast cancer. This study examines the results of a protocol of therapy for lymphedema in breast cancer patients.
  
  
  METHODS
  A total of 135 patients with lymphedema after breast cancer treatment were provided a protocol of complete decongestive therapy (CDT). This involved manual lymphatic drainage, compression garments, skin care, and range-of-motion exercises. Therapy was divided into an induction phase involving twice-weekly therapy for 8 weeks and maintenance therapy individualized to patient needs. Absolute volume and percentage of volume of lymphedema was compared before and after treatment. Also assessed was the degree of chronic pain and the need for pain medication.
  
  
  RESULTS
  Mean initial lymphedema volume was 709 mL, and the percentage of lymphedema was 31%. The induction phase of CDT reduced this to 473 mL and 18%, respectively. Before therapy, 76 patients had chronic pain and 41 required oral pain medication. CDT reduced this to 20 and 11, respectively. The degree of pain was also assessed on a numerical scale from 0 to 10. Those patients with chronic pain initially rated their pain at an average of 6.9. After treatment, this was reduced to 1.1.
  
  
  CONCLUSIONS
  Lymphedema continues to be a problem for patients with breast cancer. A program of lymphedema therapy can reduce the volume of edema and reduce pain in this population.
authors.affiliation: Department of Surgery, University of Tennessee Health Sciences Center, 956 Court Avenue, Room G228, Memphis, Tennessee 38163, USA. jhamner@utmem.edu
authors.forename: John B
authors.initials: JB
authors.lastname: Hamner
authors.forename: Martin D
authors.initials: MD
authors.lastname: Fleming
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000601:surgery*; D002908:Chronic Disease; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D004322:Drainage; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008209:Lymphedema / Q000628:therapy*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000628:therapy*; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D017592:Skin Care; D053828:Stockings, Compression
chemical_list: D000700:Analgesics