TREATMENT OF CHRONIC POSTMASTECTOMY LYMPHEDEMA WITH LOW-LEVEL LASER THERAPY - A 2.5 YEAR FOLLOW-UP

Ten women with unilateral arm lymphedema after axillary clearance (rad ical mastectomy) and radiotherapy for breast cancer received 16 treatm ent sessions with Low Level Laser Therapy (LLLT) over 10 weeks and sev en patients were followed for 36 months. The effect of LLLT was monito red by arm circumference, plethysmography, tonometry, bioimpedance and a questionnaire dealing with subjective symptoms. After treatment, ed ema volume (both extracellular and intracellular) was decreased, the t issue (except for the upper arm) progressively softened or approached a normal texture, and the patients reported improvement in aches/pains , tightness, heaviness, cramps, pins/needles, and mobility of the arm. Skin integrity was also improved and the index for risk of infection decreased. Follow-up assessment at 1, 3, 6, and 30-36 months showed va rying trends although at 30-36 months most subjective parameters and b ioimpedance derived data on ECF and ICF tended to return toward pre-tr eatment levels. Arm circumference continued to show overall improvemen t, however, with a volume reduction of the affected arm reaching 29%. Tonometry also showed maintenance of near normal values for the involv ed forearm and anterior and posterior chest; however, the upper arm sh owed progressive induration. The data suggest that laser treatment, at least initially, improved most objective and subjective parameters of arm lymphedema.