Treatment of breast cancer-related lymphedema using negative pressure massage: a pilot randomized controlled trial.

Abstract

OBJECTIVE\nEvaluate the efficacy of negative pressure massage treatment (NPMT) compared to manual lymphatic drainage (MLD) in women with chronic breast cancer-related lymphedema (LE). We hypothesized that NPMT would result in greater improvements in LE and upper limb function.\n\n\nDESIGN\nPilot single-blinded randomized controlled trial (RCT) SETTING: Health sciences university PARTICIPANTS: Of 64 women screened, 28 met eligibility requirements (i.e., >18 years of age; completed active treatment for breast cancer; had unilateral arm LE for ≥one year; were not receiving LE care; had stable LE) and were randomized to NPMT (n=15) and control group (n-13).\n\n\nINTERVENTIONS\nIntervention group received NPMT and control group MLD; both received twelve 60-minute sessions over 4-6 weeks.\n\n\nOUTCOME MEASURE(S)\nBioimpedance (L-Dex units), limb volume (ml) calculated from limb circumference, and Disability of Arm, Shoulder, Hand (DASH) questionnaire score.\n\n\nRESULTS\nOutcomes were analyzed for 28 women. Compared to the MLD group, the NPMT group demonstrated greater improvement with large ES in L-Dex scores (p=0.001; standardized mean difference (SMD) =-1.15, 95% CI -1.96 - -0.35) and interlimb volume differences (p=0.038; SMD=-0.83, 95% CI -1.60 - -0.05). Differences in DASH scores were not statistically significant (0.067).\n\n\nCONCLUSION(S)\nCompared to MLD, treatment with NPMT resulted in greater improvement in L-Dex scores and interlimb volume differences in women with unilateral upper limb LE of >1-year duration. Our findings need to be confirmed in a larger RCT.