[Treatment of postoperative lymphedema of the upper limb]

In breast cancer the overall incidence of post-therapeutic lymphedemas of the arm remains at 20% despite the use of new conservative treatments. Patients suffering from pains and heaviness require additional treatment for their swollen arm. One hundred and seventy-nine women with a post therapeutic edema of the upper limb have been treated in a special medical unit where medical and physiotherapeutic care were given as an intensive treatment for 4 weeks. More than 80% of good results were obtained with a median decrease in volume of swelling of 45%. The duration of the clinical improvement during the 6 months following the intensive first treatment was excellent for 76% of all improved cases. Treatment failure occurred in 16.2% of upper limb swelling mostly in relation to a recurrence of the disease (81%). 84.3% of cases undergoing a second intensive treatment 6 months later displayed a new decrease in volume and a new real clinical improvement. Small post therapeutic lymphedemas must be treated as soon as possible to avoid more serious delayed disorders.