Wrapping up the evidence: bandaging in breast cancer-related lymphedema-a systematic review and meta-analysis

The standard approach for breast cancer-related lymphedema (BCRL) is Complex Decongestive Therapy. This therapy involves various components, including the use of compression bandages to reduce swelling. Among these, multilayer bandage is the most frequently applied bandage in these patients. Nevertheless, alternative bandaging methods may also be effective. The current systematic review and meta-analysis of randomized-controlled trials (RCTs) aimed to compare the effectiveness of different bandaging techniques in patients with BCRL.

A search was conducted in PubMed, Web of Science, and Scopus to identify RCTs that analyzed different bandaging techniques in patients with BCRL. The methodological quality of the RCTs was assessed using the Physiotherapy Evidence Database (PEDro). The meta-analysis was performed using RevMan 5.4 software, with standardized mean differences (SMDs) calculated by comparing change scores and standard deviations between intervention and control groups. This study was registered in PROSPERO (CRD42024597170).

A total of 21 RCTs were included in the systematic review (n = 1122) and five could be meta-analyzed (n = 239). The meta-analysis did not reveal significant differences in the reduction of the affected arm volume among different bandaging techniques, including multilayer, kinesio-taping, cohesive, and alginate bandage [SMD = - 0.04, 95% confidence interval - 0.30 to 0.21; p = 0.750; I² = 0%].

The current scientific evidence does not suggest a clear advantage of one bandaging technique over another, including kinesio-taping and multilayer bandages. Further studies with larger sample sizes are warranted to better understand their potential benefits across the different stages and phases of BCRL management.