The physical treatment of upper limb edema

BACKGROUND, Edema of the upper limb, without any doubt, constitutes the mos t invalidating complication of breast carcinoma treatment. The swelling of the limb results from decreased liquid evacuation by surgical intervention at the axillary level and also by the eventual treatment by cobaltotherapy. METHOD, The physical treatment for edema of the limb consists of a combinat ion of therapies that were tested for their effectiveness in laboratories o n healthy students and also on patients who underwent surgery for breast ca rcinoma. The treatment consists of die application of manual lymphatic drai nage (type Leduc), the use of multilayered bandages, and the use of intermi ttent pneumatic compression. The population studied was represented by 220 patients who underwent breast surgery. The authors followed their evolution during the first 2 weeks of treatment. Patients were net hospitalized. The edema was measured by using marks tattooed on the skin. RESULTS. The limb that developed edema was compared with the healthy limb. The most important reduction was obtained in the first week. The decrease w as equivalent to 50% of the average of the difference between both upper li mbs. During the second week, the results obtained stabilized; however, ther e was a slight decrease at the end of the second week. CONCLUSIONS, The physical treatment of edema represents the preferred thera peutic approach, However, it must answer to well-defined criteria to be eff icient and for long-lasting effects. The physical treatment is used to trea t outpatients, allowing them to follow a normal lifestyle. Cancer 1998;83:2 835-9. (C) 1998 American Cancer Society.