Bandaging Not Just a Band-Aid for Breast Cancer Side Effect

Breast cancer lymphedema bandaging worked just as well as decongestive therapy

(RxWiki News) After breast cancer treatment, many survivors are left with arm swelling (lymphedema) that can be uncomfortable and interfere with function. Recently, researchers looked at the most effective ways to treat this condition.

A new study found that inexpensive compression bandages (elastic sleeve and glove) were just as effective in managing lymphedema as expensive and time-consuming lymphatic massage.

The researchers said that women who cannot afford hundreds of dollars’ worth of massage can be comforted knowing that bandaging may be just as good for dealing with lymphedema.

"Tell your health team if you experience any cancer treatment-related side effects."

Principal investigator of the study, Ian S. Dayes, MD, MSc, professor of oncology at McMaster University in Hamilton, Ontario, and colleagues evaluated two methods of treating lymphedema.

According to these researchers, anywhere from 6 to 30 percent of breast cancer survivors develop lymphedema, which not only alters physical appearance, but also can be emotionally distressing, increase risk of infection, reduce arm function and be uncomfortable.

The condition can develop soon after treatment and last indefinitely.

Lymphedema risk factors include surgery to remove axillary (armpit) lymph nodes, axillary radiation treatment, infection and patient obesity.

For this study, Dr. Dayes’s team enrolled 103 women previously treated for breast cancer with lymphedema between 2003 and 2009, and 95 were evaluated.

The women were randomly assigned to receive either daily massage (experimental group) or wear compression garments (control group).

Participants in the experimental group received one-hour sessions of massage called “manual lymphatic drainage” five days a week for four weeks.

After each session, the woman’s arm was wrapped with compression bandages, which were worn for the following 23 hours until the next massage.

The control group participants wore compression garments consisting of a sleeve and glove for 12 hours a day. After the 20 sessions of massage, women in the experimental group also wore the compression sleeves for 12 hours a day.

The participants were followed for one year and were assessed for quality of life and arm function during five visits with researchers.

The researchers calculated volume by measuring the circumference of both arms.

After six weeks, the researchers found that women who had the massage had a 29 percent average volume reduction in the affected arm, compared to a 22.6 percent reduction seen in women who used compression garments only.

The absolute volume reduction was 250 mL for the experimental group and 143 mL for the control group.

Women who’d been diagnosed with lymphedema for a year or less saw very little difference between the methods, with the experimental group losing 188 mL and the control coup losing 162 mL.

Differences between the two methods were more dramatic in women who had been dealing with lymphedema for longer periods of time. Lymphedemic drainage resulted in a volume loss of 328 mL, compared to 114 mL loss seen in women who used compression alone.

The researchers reported that the 20 sessions of massage, along with the garments, cost $1,500 Canadian, while the elastic sleeves cost $15 to $20 each.

“This trial was unable to demonstrate a significant improvement in lymphedema with decongestive therapy compared with a more conservative approach. The failure to detect a difference may have been a result of the relatively small size of our trial,” the researchers wrote.

This study was published in the Journal of Clinical Oncology.

The Canadian Breast Cancer Research Alliance funded the research.

Review Date: 
November 20, 2013