Bunce IH, Mirolo BR, Hennessy JM, Ward LC, Jones LC.
Post-mastectomy lymphoedema treatment and measurement.
Med J Aust 1994 Jul 18;161(2):125-8

Wesley Clinic for Haematology and Oncology, Wesley Cancer Care Centre, Auchenflower, Qld.

OBJECTIVE: To evaluate multimodal treatment (massage, pneumatic compression,
bandaging and education) of post-mastectomy lymphoedema and to review methods of
measurement of lymphoedema. DESIGN: Prospective cohort study with 12 months'
follow-up. PATIENTS: Twenty-five consecutive women referred for lymphoedema
examination after mastectomy to a private day-patient clinic attached to a
tertiary referral hospital. INTERVENTION: Patients received multimodal therapy,
including education on self-management techniques, for four weeks. MAIN OUTCOME
MEASURES: Changes in body weight, limb circumference and volume, and patient
reports of self-management (exercise, massage, bandaging and sleeve wearing).
RESULTS: Excess limb volume decreased by approximately 40% immediately after
treatment and by over 50% at 6 months' follow-up, remaining stable to 12 months'
follow-up. Self-management that required assistance (massage and bandage wearing)
declined more after treatment than did exercise or compression sleeve wearing.
Correlations between body mass and limb volume and self-management and limb
volume reduction were non-significant. CONCLUSION: Multimodal therapy reduced
lymphoedematous limb volume by at least half in 18 of 25 patients. Patients can
maintain these reductions independently through exercise and sleeve wearing and
without further treatment. We used a replicable method of measuring lymphoedema,
which we recommend for adoption by researchers in this field.