Ahmed Omar, M.T., Abd-El-Gayed Ebid, A., & El Morsy, A.M. (2011). Treatment of post-mastectomy lymphedema with laser therapy: Double blind placebo control randomized study. The Journal of Surgical Research, 165(1), 82–90.

To evaluate the effect of low-level laser therapy (LLLT) on limb volume, shoulder mobility, and grip strength

Patients were randomized to treatment and placebo control groups. The treatment group received LLLT at an average dose of 1.5 J/cm² for 20 minutes three times per week for 36 sessions. In the placebo group, the patients were set up with the same parameters of therapy but the machine was not turned on. All patients were advised to perform the same arm and shoulder exercises daily. Patients were evaluated every 4 weeks for 12 weeks.

• The study sample (N = 50) was comprised of female patients with breast cancer.
• Mean age of the sample was 54.06 years.
• All patients had axillary node dissection and unilateral arm lymphedema.
• Patients had arm circumference increases in the affected arm of 2–8 cm.
• Patients with severe lymphedema were excluded.
• Seventy-two percent of patients had modified radical mastectomy.
• Lymphedema was in the dominant arm in 78% of patients.
• Mean duration of lymphedema was 14 months and average time since surgery was 40 months.

The study took place in an outpatient setting in Egypt.

The study has clinical applicability for late effects and survivorship.

The study used a randomized double-blind placebo-controlled design.

• Arm circumference was measured.
• Grip strength was measured with a dynamometer.
• Goniometer measured shoulder range of motion.

The laser group had greater reduction in limb volume than controls. The difference was significant at 8 and 12 weeks (p < 0.01).  At 16 weeks, total limb circumference was 31 in the laser group and 23 in the control group. Shoulder mobility was better in the laser group and significantly better than controls at 12 weeks (p < 0.01).  Grip strength improved in both groups. At 8 and 12 weeks, grip strength improvement was significantly higher in the laser treatment group (p < 0.01).

 LLLT reduces lymphedema arm volume and increased shoulder mobility and grip strength in women after mastectomy.

• The study sample was small, with less than 100 participants.
• Subject withdrawals were greater than or equal to 10%.
• The study was of short duration, so long-term efficacy is not clear.

Low-level laser therapy can reduce lymphedema volume and improve extremity strength and mobility. The study showed that 14% of patients did not adhere to receiving all treatments, which has also been shown in other studies of LLLT. The need for patients to make multiple visits for treatments may limit the practicality of the approach. Effects over the longer term are unclear.