title: Manual lymphatic drainage versus exercise in the early postoperative period for breast cancer.
abstract: OBJECTIVE
  To compare the effect of active exercise and manual lymphatic drainage (MLD) on postoperative wound healing complications, shoulder range of motion (ROM) and upper limb (UL) perimetry in women undergoing radical mastectomy for breast cancer.
  
  
  METHODS
  Controlled non-randomized clinical trial with 89 women undergoing breast cancer surgery with axillary lymph node dissection (Brazilian Registry of Clinical Trials: 906). Women were matched for staging, age and body mass index, with 46 women allocated to the exercise group and 43 in the MLD group, receiving 2 weekly sessions during one month. Assessments were performed in the preoperative and 60 d after surgery, including inspection, palpation, goniometry and perimetry.
  
  
  RESULTS
  No significant difference existed between groups relative to individual and clinical surgical characteristics. The incidence of seroma, number of punctures performed, dehiscence and infection was similar in both groups. A comparison of shoulder ROM and UL perimetry between groups, obtained in the preoperative and postoperative period, did not show any significant difference.
  
  
  CONCLUSIONS
  The performance of active exercise or MLD did not demonstrate difference in wound healing complications, shoulder ROM and UL perimetry at 60 d after surgery, suggesting that these techniques may be employed, according to the complaints or symptoms of each woman and physical therapist experience.
authors.affiliation: Physical Therapy Section-Prof. Dr. José Arostodemo Pinotti Women's Hospital-Integral Healthcare Center (CAISM), Universidade Estadual de Campinas (Unicamp) , Campinas , Brazil .
authors.forename: Mariana Maia Freire
authors.initials: MM
authors.lastname: de Oliveira
authors.forename: Laura Ferreira
authors.initials: LF
authors.lastname: de Rezende
authors.forename: Maria Teresa Pace
authors.initials: MT
authors.lastname: do Amaral
authors.forename: Marcela Ponzio
authors.initials: MP
authors.lastname: Pinto e Silva
authors.forename: Sirlei Siani
authors.initials: SS
authors.lastname: Morais
authors.forename: Maria Salete Costa
authors.initials: MS
authors.lastname: Gurgel
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D004322:Drainage / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008209:Lymphedema / Q000209:etiology / Q000534:rehabilitation*; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000534:rehabilitation*; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D012785:Shoulder Joint / Q000503:physiopathology; D016896:Treatment Outcome; D034941:Upper Extremity; D014945:Wound Healing / Q000502:physiology
keywords: Breast cancer; active exercise; manual lymphatic drainage