Breast Cancer Related Lymphoedema
Conditions
Keywords
Breast Cancer, Lymphoedema, Manual lymphatic drainage, Decongestive lymphatic therapy
Brief summary
Axillary lymph nodes are the main site of metastasis in breast cancer. If positive axillary lymph nodes are present, an axillary lymph node dissection (ALND) is usually performed. This procedure improves disease-free survival but comes with the risk of lymphoedema as a result of disrupted lymphatic channels. Breast cancer-related lymphoedema (BCRL) is associated with considerable morbidity, which is why proven measures to reduce its incidence would improve patient outcomes. We aimed to investigate whether a regime of manual lymphatic drainage and exercise, supervised by a manual lymphatic drainage therapist compared to standard care would reduce the incidence of breast cancer-related lymphoedema in patients undergoing ALND.
Detailed description
Eligible patients were those in whom a primary operable breast cancer is diagnosed and in whom surgery is planned to include ALND. Patients with recurrent carcinoma, previous axillary surgery/radiotherapy or any previous arm/axillary pathology leading to arm volume changes will be excluded. Eligible participants will be identified at the breast multidisciplinary meeting and will be informed of the study and given a written information sheet. Patients who choose to participate will be asked to fill in a written consent form. Patients allocated to the decongestive lymphatic therapy group will undergo intervention for a total period of 3 months. This will consist of 2 visits to a qualified practitioner in Dr Vodder manual lymphatic drainage therapist, one at the start of the 3-month period and again 6 weeks later. Patients in both groups will also be instructed to perform self-MLD on a daily basis and will be taught a series of exercises to be performed on a daily basis. Compression hosiery will be fitted to be worn during the exercises.
Interventions
COMBINATION_PRODUCTDecongestive lymphatic therapy (DLT)
Manual lymphatic drainage
OTHERStandard Care
Sponsors
Norfolk and Norwich University Hospitals NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
No minimum to 120 Years
Healthy volunteers
No
Inclusion criteria
* Patients with a new diagnosis of primary operable breast cancer * Surgery will involve axillary lymph node clearance
Exclusion criteria
* Patients with recurrent breast cancer * Patients with previous axillary surgery * Patients with previous axillary radiotheraphy * Patients with previous arm/axillary pathology leading to arm volume changes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Absolute difference in arm volumes | Through study duration, approximately 36 months | The primary outcome was the absolute difference in arm volumes between the affected and the contralateral arms. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patients adherence to the protocol stated exercises for 3 months post surgery | Through study duration, approximately 36 months | The patient's acceptability of physiotherapy exercises will be sought via questionnaires |
Countries
United Kingdom
Outcome results
None listed