Huang, T.W., Tseng, S.H., Lin, C.C., Bai, C.H., Chen, C.S., Hung, C.S., … Tam, K.W. (2013). Effects of manual lymphatic drainage on breast cancer-related lymphedema: A systematic review and meta-analysis of randomized controlled trials. World Journal of Surgical Oncology, 11, 1–8.
To examine the evidence on manual lymphatic drainage (MLD) in the prevention or management of limb edema in postsurgical women with breast cancer
The literature search retrieved 170 references. Authors independently evaluated methodological quality in terms of blinding, attrition, and use of intention-to-treat analysis. No specific tool for evaluation was described.
Patients were undergoing multiple phases of care.
Some trials focused on prevention and others involved treatment of lymphedema. Nine studies were included in meta-analysis. Findings showed a risk ratio of 0.063 (95% CI 0.14, 2.83, p = 0.54). High heterogeneity existed. Standard mean difference (SMD) findings showed no benefit of MLD, with SMD = 75.12 (95% CI -9.34, 159.58). Findings showed that the addition of MLD to other individual components of complete rehabilitation such as compression bandaging does not show a significant benefit in reducing arm volume. Overall published reports of MLD show conflicting results. No significant differences were found in the incidence of lymphedema between patients treated with MLD or not.
MLD does not add significant benefit for prevention or management of lymphedema in patients with breast cancer.
Findings suggest that MLD as an adjunctive treatment is not effective in preventing or managing arm lymphedema in women with breast cancer who have had axillary lymph node excision.