title: Therapy modalities to reduce lymphoedema in female breast cancer patients: a systematic review and meta-analysis.
abstract: The aim of the present study was to evaluate the effects of compression bandages, sleeves, intermittent pneumatic compression (IPC) and active exercise on the reduction of breast cancer-related lymphoedema (BCRL). A systematic literature search up to the year January 2016 was performed in CINAHL, Cochrane Register of Controlled Trials, Embase, International Clinical Trials Registry Platform (WHO), PEDro and PubMed. Inclusion criteria were (1) RCTs, (2) reported adequate statistics for meta-analysis, (3) English or German language. Exclusion criteria were (1) effects of drugs, hormonal, radiation and surgical procedures, (2) studies with children, (3) non-breast cancers, lower extremity oedema, (4) impact on fatigue only, diets or sexually transmitted diseases, (5) cost-analysis only and (6) non-carcinogenic syndromes or (7) prevention of breast cancer. After scoring the methodological quality of the selected studies, data concerning volume reduction of the oedema swelling were extracted. Thirty-two studies were included in this systematic review. Nine studies were selected for the RCT-based studies and 19 studies were included in the pre-post studies-based random-effects meta-analyses. All conclusions should be taken with precautions because of the insufficient quality of the selected papers. Exercise seems beneficial in reducing oedema volume in BCRL. IPC seems beneficial in helping to reduce the oedema volume in the acute phase of treatment. Compression sleeves do not aid in the volume reduction in the acute phase; however, they do prevent additional swelling.
authors.affiliation: Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland. slavko.rogan@bfh.ch.|Academy of integrative Physiotherapy and Training Education, Grenzach-Wyhlen, Germany. slavko.rogan@bfh.ch.
authors.forename: Slavko
authors.identifier: 0000-0003-0865-2575
authors.initials: S
authors.lastname: Rogan
authors.affiliation: Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.|Faculty for Sports and Rehabilitation Science, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Taeymans
authors.affiliation: Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
authors.forename: Helena
authors.initials: H
authors.lastname: Luginbuehl
authors.affiliation: Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
authors.forename: Martina
authors.initials: M
authors.lastname: Aebi
authors.affiliation: Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Mahnig
authors.affiliation: Rehabilitation Sciences & Physiotherapy, University of Antwerp, Antwerp, Belgium.
authors.forename: Nick
authors.initials: N
authors.lastname: Gebruers
mesh_terms: D000072656:Breast Cancer Lymphedema / Q000628:therapy*; D003131:Combined Modality Therapy / Q000295:instrumentation* / Q000379:methods*; D058128:Compression Bandages; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D011788:Quality of Life; D012107:Research Design; D016896:Treatment Outcome
keywords: Axillary dissection or breast cancer; Lymphoedema; Mastectomy; Women