Effect of Complete Decongestive Therapy (CDT) in Upper Limb Lymphedema in Breast Cancer Patients

Objective: To find long term effectiveness of complete decongestive therapy to reduce lymphedema and improvement of quality of life in the patients of unilateral upper limb lymphedema of post radical mastectomy.

Materials and method: Patients were recruited from January 2011 to December 2012. Each patient received an intensive phase of complete decongestive therapy for 10 days from out patients unit, Department of Physiotherapy, CMC&H Ludhiana. Self care and self management techniques were taught to the patients and relatives.The patients were followed up every month for up to 3months.The base line assessment of oedematous limb were assessed with modified truncated cone method and their quality of life was assessed with European organization for research and treatment of cancer quality of life questionnaires - core 30 questions (EORTC- LYMQLQ ARM- C 30).

Result: Forty five female patients with lymphedema developed after mastectomy was analyzed in this study.The mean age of subjects was 48.44 years. Volume was reduced by 80.22 (95% CI: -96.71 to -63.73) from baseline to 3rd month (p<0.0001). There was significant mean change in QOL at 2nd month as compared to baseline [69.95 (95% CI: 66.49 to 73.42); p<0.0001]. Volume of affected limb was similar to the normal limb at 3rd month (normal limb: 312.38±82.20 vs. affected limb: 324.44±82.19; p=0.48).

Conclusion: Complete decongestive therapy is effective in lymphedema and improves the quality of life and required to assess the effectiveness of self management under supervision.