Postmastectomy lymphoedema. Treatment and a five-year follow-up study

Area of Science:

• Oncology
• Surgical Complications
• Rehabilitation Medicine

Background:

• Arm lymphoedema is a frequent complication following mastectomy and radiotherapy for breast cancer.
• Prospective 5-year follow-up study to assess arm oedema development and conservative compression treatment efficacy.
• Investigated 226 patients post-mastectomy, with 157 followed for five years.

Purpose of the Study:

• To investigate the incidence and progression of arm oedema after mastectomy.
• To evaluate the effectiveness of conservative compression therapies in managing postmastectomy arm swelling.
• To identify factors influencing the development of severe lymphoedema.

Main Methods:

• Oedema assessed by water displacement volume comparison between arms, with >= 100 ml difference defined as oedema.
• Three compression treatment modalities evaluated: stockings, Flowtron, and Lympha-Press with sleeves.
• Longitudinal follow-up over five years to monitor oedema and treatment response.

Main Results:

• 20% of patients (46/226) developed post-operative oedema, with most cases appearing within the first year.
• Average oedema volume was 418 ml; severe cases (>750 ml) were associated with post-operative irradiation and lymph node involvement.
• Compression therapy showed significant efficacy: stockings (54% reduction), stockings + Lympha Press (68% reduction), and Flowtron (50% reduction).
• Cessation of compression therapy frequently led to relapse of swelling.

Conclusions:

• Conservative compression therapy is a beneficial and necessary treatment for controlling postmastectomy arm swelling.
• Various compression modalities are effective, with prolonged treatment required to manage progression.
• Stocking application is a simple and effective method for managing post-operative oedema, particularly in the first year after surgery.