Breast Cancer Related Lymphedema and Conservative Therapies
2 Department of Physical Medicine and Rehabilitation, Çukurova University Faculty of Medicine, Adana, Turkey
Lymphedema is characterized by generalized or regional accumulation of protein-rich interstitial fluid that occurs as a consequence of congenital or acquired disruption of lymphatic circulation. Cancer-related lymphedema is the most common cause of secondary upper and lower extremity lymphedema. Secondary arm lymphedema is a chronic and disabling condition which affects a significant number of women who undergo breast cancer treatment. The incidence of breast cancer-related lymphedema was reported to be between 2.4 to 56%. Extensive surgical nodal clearing and irradiation are the most important risk factors for the development of lymphedema. Besides preventive approaches of treatment related complications and lymphedema, various therapeutic interventions have been proposed to treat this disabling condition. In the absence of well-designed randomized studies, consensus has not been attained concerning the appropriate treatment of lymphedema. Complex decongestive therapy, manual lymphatic drainage, self-adminitered lymphatic drainage, pneumatic pumps, laser therapy, oral pharmaceuticals, compression bandaging and garments, limb exercises and elevation are among the common conservative therapies used for managing lymphedema. This review overviews the risk factors, assessment methods, preventive approaches and treatment regimens that have been used for the management of lymphedema.
Keywords : Breast cancer, lymphedema, conservative therapy