Brennan MJ, Miller LT.
Overview of treatment options and review of the current role and use of
compression garments, intermittent pumps, and exercise in the management of
Cancer 1998 Dec 15;83(12 Suppl American):2821-7

Bridgeport Hospital, Connecticut, USA.

BACKGROUND: Lymphedema is a relatively frequent complication following the
management of breast carcinoma. Numerous therapeutic interventions have been
offered to treat this potentially disabling and disfiguring condition. Consensus
has not been attained among oncologists, surgeons, psychiatrists, and physical
therapists concerning the appropriate treatment of lymphedema. METHODS: This
review provides an overview of those treatment regimens that have been used in
the past and, in some instances, have gone on to provide the foundation for the
most widely prescribed interventions currently employed for the management of
upper extremity lymphedema following breast carcinoma treatment. The use of
intermittent pneumatic compression pumps as a part of an integrated
multidisciplinary treatment approach incorporating garments, exercises, and
massage also is discussed. RESULTS: A review of available literature suggests
that a variety of traditional and commonly available techniques, when used
appropriately in a multidisciplinary fashion, may lessen the cosmetic and
physical impairments associated with acquired lymphedema. The role of surgery is
unclear. Pharmacotherapies are a promising adjunct to manual and mechanical
therapies. CONCLUSIONS: The appropriate use of readily available treatment
approaches may lessen the severity of acquired lymphedema following breast
carcinoma therapy. A comprehensive therapeutic approach should be employed in the
management of lymphedema, including attention to the functional, cosmetic, and
emotional sequelae of this potentially disabling condition. To that end, a
recommendation for a comprehensive treatment regimen is provided.