The present study evaluated the effect of manual lymphatic drainage on lymphedema of the upper limb after previous axillary lymphadenectomy/sentinel node biopsy during the maintenance phase of lymphedema after breast cancer surgery.

It included 30 patients after surgical treatment of unilateral breast cancer undergoing ten manual lymphatic drainages within eight consecutive weeks. It measured upper limb circumference before and after the study in each patient and subjected them to complete two specialized EORTC questionnaires (QLQ-C30 and QLQ-BR23).

The study found-

• The average time between surgery and admission into this investigation was 32.5 months.
• Lymphedema for an average of 19.8 months at the beginning of the study.
• At the end of a series of manual lymphatic drainages, an average of 3% (1.5-5.6%) volume decrease of the limb with lymphedema.
• On the contrary, only 0.4% average volume loss on the healthy (control) upper limb.
• 57% (37-88%) average reduction of lymphedema volume after therapy.
• After a series of manual lymphatic drainages, the results of the EORTC QLQ-C30 questionnaire revealed marked improvement in physical and role functions, fatigue, nausea and vomiting, pain, dyspnea, and constipation.
• Likewise, the results of the EORTC QLQ-BR23 questionnaire showed a marked improvement in the arm and breast symptoms.
• No significant deterioration in any of the monitored parameters.

This study shows a positive effect of manual lymphatic drainage on the maintenance phase of lymphedema in patients after breast cancer surgery. The questionnaires showed a significant improvement in hand and arm symptoms and the other functions and symptoms affecting the quality of life. Further studies are needed to back these findings.

Kristína C, Marta N. Effect of manual lymphatic drainage on upper limb lymphedema after surgery for breast cancer. Ceska Gynekol. 2022;87(5):317-323. English. Doi: 10.48095/cccg2022317. PMID: 36316211.