title: Compression garments versus compression bandaging in decongestive lymphatic therapy for breast cancer-related lymphedema: a randomized controlled trial.
abstract: BACKGROUND
  Lymphedema as a result of curative surgery for breast cancer can lead to long-term morbidity. Decongestive lymphatic therapy (DLT) is recognized as an optimal management strategy for patients with moderate symptomatologies, but there is little data in regard to the most effective means of providing compression therapy within a DLT protocol. We conducted a randomized trial of two forms of compression therapy within the initial treatment phase of a DLT protocol for breast cancer-related lymphedema.
  
  
  METHODS
  Subjects were required to have mild-moderate lymphedema (10-40% volume difference) acquired as a result of curative breast cancer surgery and were randomized to compression bandaging or garments within the initial treatment phase of a DLT protocol. Primary endpoint was change in affected limb volume assessed via volumetry, and secondary endpoints were symptom control and upper extremity function assessed via visual analogue scales and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, respectively. Endpoints were assessed at day 10 of treatment and at 3 months and compared to baseline.
  
  
  RESULTS
  Twenty-one subjects were available for analysis. The group receiving bandaging experienced greater median volume reductions at 10 days (70 vs. 5 mL; p = 0.387) and at 3 months (97.5 vs. 50 mL; p = 0.182). The bandaging group also experienced a greater increase in median DASH scores at 10 days (+20.9 vs. +5; p = 0.143) and at 3 months (+18.4 vs. +3.3; p = 0.065).
  
  
  CONCLUSIONS
  Within the initial treatment phase of a DLT protocol for acquired, breast cancer-related lymphedema, compression bandaging may lead to greater volume reduction but worse upper extremity functional status (higher DASH scores) as compared to compression garments.
authors.affiliation: Occupational Therapy, Capital District Health Authority, NS Rehabilitation Center, 1341 Summer Street, Halifax, NS, B3H 4KY, Canada. myrna.king@cdha.nshealth.ca
authors.forename: Myrna
authors.initials: M
authors.lastname: King
authors.forename: Audrey
authors.initials: A
authors.lastname: Deveaux
authors.forename: Heather
authors.initials: H
authors.lastname: White
authors.forename: Daniel
authors.initials: D
authors.lastname: Rayson
mesh_terms: D000328:Adult; D000368:Aged; D001458:Bandages; D001943:Breast Neoplasms / Q000601:surgery*; D003020:Clothing; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D011312:Pressure; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D034941:Upper Extremity