Leduc O, Leduc A, Bourgeois P, Belgrado JP.
The physical treatment of upper limb edema.
Cancer 1998 Dec 15;83(12 Suppl American):2835-9

Academic Department, Physical Therapy, University of Brussels, Belgium.

BACKGROUND: Edema of the upper limb, without any doubt, constitutes the most
invalidating complication of breast carcinoma treatment. The swelling of the limb
results from decreased liquid evacuation by surgical intervention at the axillary
level and also by the eventual treatment by cobaltotherapy. METHOD: The physical
treatment for edema of the limb consists of a combination of therapies that were
tested for their effectiveness in laboratories on healthy students and also on
patients who underwent surgery for breast carcinoma. The treatment consists of
the application of manual lymphatic drainage (type Leduc), the use of
multilayered bandages, and the use of intermittent pneumatic compression. The
population studied was represented by 220 patients who underwent breast surgery.
The authors followed their evolution during the first 2 weeks of treatment.
Patients were not hospitalized. The edema was measured by using marks tattooed on
the skin. RESULTS: The limb that developed edema was compared with the healthy
limb. The most important reduction was obtained in the first week. The decrease
was equivalent to 50% of the average of the difference between both upper limbs.
During the second week, the results obtained stabilized; however, there was a
slight decrease at the end of the second week. CONCLUSIONS: The physical
treatment of edema represents the preferred therapeutic approach. However, it
must answer to well-defined criteria to be efficient and for long-lasting
effects. The physical treatment is used to treat outpatients, allowing them to
follow a normal lifestyle.