Simple compression bandages as effective as massage for lymphedema

McMaster University researchers found no difference in patients with breast cancer who used simple compression bandages to treat lymphedema compared with those who underwent daily lymphatic massage.

“In the future, patients who receive or can only afford elastic sleeves and gloves should be comforted knowing that their care has not been compromised,” said principal investigator Ian Dayes, MD, MSc, FRCP(C), associate professor of oncology for the Michael G. DeGroote School of Medicine at McMaster University in Hamilton, Ontario, Canada. The research was published in the Journal of Clinical Oncology (2013; doi:10.1200/JCO.2012.45.7192).

Lymphedema affects 6% to 30% of breast cancer patients and can result in discomfort, reduced arm function, infection, and emotional upset. The swelling complication is more likely in patients who are obese, have infection, or receive additional surgery or radiation. Lymphedema can last indefinitely.

The research team followed more than 100 women at six Canadian breast cancer treatment centers for a full year. One group wore elastic compression sleeve and glove garments on the arm for 12 waking hours a day.

The other group received an hour of lymphatic drainage massage from trained therapists each weekday for 4 weeks along with exercise and skin care. These participants had compression bandages left on the arm and hand for the rest of the 24-hour day. After the month of treatment, these patients wore an elastic compression sleeve and glove for daytime wear, the same as the first group.

Regular measurements of arm volume, arm function, and quality of life were obtained, but no appreciative difference was found between the treatments. The mean reduction of excess arm volume was 29.0% in the patients who received massage and 22.6% in the patients who received the compression bandages.

The authors explained that their study was unable to detect an improvement in lymphedema with massage, but they also said that the failure to detect a difference might be due to the relatively small size of the trial. The trial enrolled 103 women, 95 of whom were evaluable.

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