da Silva Leal, N.F., Carrara, H.H., Vieira, K.F., & Ferreira, C.H. (2009). Physiotherapy treatments for breast cancer-related lymphedema: A literature review. Revista Latino-Americana De Enfermagem, 17(5), 730–736.

To present physiotherapy modalities applied for lymphedema therapy through a systematic literature review

Databases searched were Latin American and Caribbean Literature (LILACS), PubMed, and SciELO, covering periods from 1981–2009, 1951–2009, and 2001–2004, respectively. Also, data from physiotherapy textbooks were surveyed. Search keywords were post mastectomy lymphedema, physiotherapy upper limb lymphedema, complex decongestive physiotherapy, and manual lymphatic drainage. Inclusion and exclusion criteria were not described.

No description was provided of the total number of studies reviewed initially, of how identified articles were assessed, or hwo studies were selected and evaluated. 

• Nineteen studies were included in the report.
• The sample range across studies was 3–537.
• All samples included women with lymphedema post-breast cancer treatment.

Physiotherapy used for lymphedema treatment includes complex decongestive therapy (CDT), pneumatic compression (PC), high-voltage electrical stimulation (HVES), and laser therapy. Better results are obtained with combined techniques. CDT is the most used protocol, and its association with PC has demonstrated efficacy. The new techniques HVES and laser demonstrate satisfactory results.

CDT has the strongest scientific support. Its application together with PC has demonstrated efficacy, and new techniques with satisfactory results are being studied, such as HVES and laser therapy. Combined physiotherapy techniques produce the most beneficial effects.

Clinicians should select the best combination based on a detailed assessment of individual cases.