Cho, Y., Do, J., Jung, S., Kwon, O., & Jeon, J.Y. (2016). Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Supportive Care in Cancer, 24, 2047–2057.
To assess the benefits of standard physical therapy (PT) compared to PT with manual lymph drainage (MLD) on lymphedema incidence, shoulder function, pain, and cording in patients with breast cancer with axillary web syndrome (AWS)
PHASE OF CARE: Late effects and survivorship
This was a prospective, randomized trial of patients with breast cancer who had undergone surgery and were randomized to two therapy interventions.
All patients benefited from postoperative PT, but patients who had PT and MLD did not develop lymphedema. Measurements were not taken weekly, so when the changes in arm volume occurred cannot be identified. This study supports wearing compression during therapy. Patients are at risk for lymphedema even when engaging in supervised exercise.
Nurses need to vigilantly monitor for symptoms of pain in the ipsilateral limbs of patients with breast cancer to prevent loss of function, chronic pain, and lymphedema. As seen in this study, even pain at level 3 is significant. Patients need early PT referral to prevent arm disability and early lymphedema therapy.