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Annals of Oncology Advance Access originally published online on October 3, 2006
Annals of Oncology 2007 18(4):639-646; doi:10.1093/annonc/mdl182
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© 2006 European Society for Medical Oncology

reviews

A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment

AL Moseley1,*, CJ Carati2 and NB Piller3

1 School of Nursing & Midwifery, University of South Australia, Adelaide
2 Department of Anatomy, School of Medicine, Flinders University, Adelaide
3 Department of Surgery & Lymphoedema Assessment Clinic, Flinders University & Medical Centre, Adelaide, Australia

* Correspondence to: Ms A. L. Moseley, Institute of Women's Health, Department of Gynaecological Oncology, University College London, London, UK; E-mail: amanda.moseley{at}yahoo.com.au

Secondary arm lymphoedema is a chronic and distressing condition which affects a significant number of women who undergo breast cancer treatment. A number of health professional and patient instigated conservative therapies have been developed to help with this condition, but their comparative benefits are not clearly known. This systematic review undertook a broad investigation of commonly instigated conservative therapies for secondary arm lymphoedema including; complex physical therapy, manual lymphatic drainage, pneumatic pumps, oral pharmaceuticals, low level laser therapy, compression bandaging and garments, limb exercises and limb elevation. It was found that the more intensive and health professional based therapies, such as complex physical therapy, manual lymphatic drainage, pneumatic pump and laser therapy generally yielded the greater volume reductions, whilst self instigated therapies such as compression garment wear, exercises and limb elevation yielded smaller reductions. All conservative therapies produced improvements in subjective arm symptoms and quality of life issues, where these were measured. Despite the identified benefits, there is still the need for large scale, high level clinical trials in this area.

Key words: breast cancer, conservative therapies, lymphoedema

Received for publication April 10, 2006. Revision received June 13, 2006. Accepted for publication June 23, 2006.


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