Comparing two treatment methods for post mastectomy lymphedema: complex decongestive therapy alone and in combination with intermittent pneumatic compression.

ABSTRACT

There is no cure for breast cancer related lymphedema. This study was conducted to compare two treatment methods for postmastectomy lymphedema Complex Decongestive Therapy (CDT) and Modified CDT (MCDT) combined with Intermittent Pneumatic Compression (IPC). One hundred and twelve patients referred to the Lymphedema Clinic of the Iranian Center for Breast Cancer in 2008, were included in a randomized clinical trial. They were randomly allocated into two equal groups receiving daily CDT alone or in combination with IPC. The volume reduction of the upper limb was measured by water displacement volumetry. No statistically significant differences in demographic and clinical variables between the two groups were observed. During the intensive phase (phase I) of treatment, CDT alone yielded a significantly higher mean volume reduction than the combination modality (43.1% vs. 37.5%; p = 0.036). Limb volume measured three months following treatment, showed 16.9% volume reduction by CDT alone, and 7.5% reduction by MCDT plus IPC. This study demonstrated that the use of CDT alone, or in combination with IPC significantly reduced limb volume in patients with post mastectomy lymphedema. CDT alone provided better results in both treatment phases. Further studies will help to define the role of multidisciplinary approaches in the management of postmastectomy lymphedema.