The effects of complex decongestive therapy on pain and functionality in individuals with breast cancer who developed adhesive capsulitis due to lymphedema: an evaluation by an isokinetic computerized system

Management of lymphedema is really a matter in patients with breast cancer

Lymphedema is a prevalent complication affecting patients with breast cancer, greatly impacting their quality of life. This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in patients with breast cancer. Diagnosis relies on clinical evaluation and objective measures, including arm circumference and volumetric assessments, along with lymphoscintigraphy and ultrasonic measurements. Treatment primarily involves complex decongestive physical therapy, comprising manual lymphatic drainage, compression therapy, exercise, and meticulous skin care. These interventions aim to reduce swelling, alleviate discomfort, and prevent further complications. Additionally, lifestyle modifications such as avoiding extreme temperatures and maintaining proper hygiene are essential. Flavonoids can be used for drug therapy. Despite its prevalence, lymphedema often receives inadequate attention in clinical practice, emphasizing the importance of raising awareness and enhancing medical services for affected individuals. Clinicians play a pivotal role in educating patients about preventive measures and ensuring timely intervention. Overall, a comprehensive approach encompassing early diagnosis, multidisciplinary management, and patient education is essential to mitigate the burden of lymphedema in patients with breast cancer and improve their overall well-being.

Complete Decongestive Therapy Effect on Breast Cancer Related to Lymphedema: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

PURPOSE

To review and analyze critically the available evidence for Complete Decongestive Therapy Effect on Breast Cancer Related to Lymphedema.

DATA SOURCES

Publications were retrieved from the major database search engines, included  Google scholar, EBSCO host, and PubMed database. The search terms including: "Complete decongestive therapy (CDT)", "breast cancer", "Breast cancer related to lymphedema (BCRL)" "breast surgery" and "mastectomy".

STUDY SELECTION

The studies were initially selected based on keywords associated with inclusion criteria. Then, articles were chosen based on their titles. Then, based on the fill text and design, randomized control with a comprehensive description of the outcomes. The authors analyzed 3,181 articles, of which 15 randomized controlled trials met inclusion criteria with no publication date constraint.

DATA EXTRACTION

Each article's authors, nations, participants, outcomes variables, measuring instruments, intervention technique and follow-up, outcomes, and results were retrieved. After reaching consensus among authors, study quality was evaluated using the Jadad scale, and risk of bias was determined using the Cochrane Rob2 tool.

DATA SYNTHESIS

The levels of evidence were of excellent quality. The retrieved articles were of "high" methodological caliber. The major outcome variables were in QOL, pain, ROM and edema. The effect size of CDT on QOL was 2.347 (95% CI: -1.41, 6.11) (p=0.22). Pain was -0.068 (95% CI: -35.21) (p=0.64). ROM was 0.324 (95% CI: -0.44,0.09) (p=0.41) and edema was -2.9 (95% -1.53,1.11) (p=0.76).

CONCLUSIONS

The CDT is still recommended as the primary therapy for BCRL and is regarded the most practical and cost-effective treatment for BCRL. This result recommends patients to perform CDT to improve their QOL, ROM, and to lessen pain and edema volume. To improve the body of evidence supporting the effectiveness of the CDT on BCRL, additional trials with bigger sample sizes, longer follow-ups, blindness outcomes, and patient compliance evaluations are required.