title: Combining Manual Lymph Drainage with Physical Exercise after Modified Radical Mastectomy Effectively Prevents Upper Limb Lymphedema.
abstract: Upper limb lymphedema is a common complication after radical mastectomy in patients with breast cancer. In this study, we examined the efficacy of self-manual lymph drainage (MLD) after modified radical mastectomy for the prevention of upper limb lymphedema, scar formation, or shoulder joint dysfunction in breast cancer patients.
  
  
  
  Breast cancer patients scheduled for modified radical mastectomy were randomly apportioned to undergo physical exercise only (PE group, the control; n = 500) or self-MLD as well as exercise (MLD group; n = 500) after surgery. In the PE group, patients started to undertake remedial exercises and progressive weight training after recovery from anesthesia. In the MLD group, in addition to receiving the same treatments as in the PE group, the patients were trained to perform self-MLD on the surgical incision for 10 min/session, 3 sessions/day, beginning after suture removal and incision closure (10 to 30 days after the surgery). Scar formation was evaluated at one week, and 1, 3, 6, and 12 months after the surgery, respectively. Upper limb circumference and shoulder abduction were measured 24 h before surgery, and at one week, and 1, 3, 6 and 12 months after the surgery.
  
  
  
  Compared to those in the PE group, patients in MLD group experienced significant improvements in scar contracture, shoulder abduction, and upper limb circumference.
  
  
  
  Self-MLD, in combination with physical exercise, is beneficial for breast cancer patients in preventing postmastectomy scar formation, upper limb lymphedema, and shoulder joint dysfunction.
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Lijuan
authors.initials: L
authors.lastname: Zhang
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Aiqun
authors.initials: A
authors.lastname: Fan
authors.affiliation: 2 School of Nursing, Sun Yat-Sen University , Guangzhou, People's Republic of China .
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Yan
authors.initials: Y
authors.lastname: He
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Huiting
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Huizhen
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Qiaoling
authors.initials: Q
authors.lastname: Zhong
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Feng
authors.initials: F
authors.lastname: Liu
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Luo
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Liping
authors.initials: L
authors.lastname: Zhang
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Hailin
authors.initials: H
authors.lastname: Tang
authors.affiliation: 1 Sun Yat-Sen University Cancer Center , Guangzhou, People's Republic of China .
authors.forename: Mingzhu
authors.initials: M
authors.lastname: Xin
mesh_terms: D000328:Adult; D000368:Aged; D000072656:Breast Cancer Lymphedema / Q000209:etiology / Q000628:therapy*; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008405:Massage; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D034941:Upper Extremity / Q000503:physiopathology