Forner-Cordero, I., Munoz-Langa, J., Forner-Cordero, A., & DeMiguel-Jimeno, J.M. (2010). Predictive factors of response to decongestive therapy in patients with breast-cancer-related lymphedema. Annals of Surgical Oncology, 17(3), 744–751.

To identify predictive factors of response to decongestant treatment through univariate and multivariate analysis

Patients received complex decongestive treatment with manual lymphatic drainage (45 minutes) and pressotherapy with pneumatic multichambered device between 50 and 80 mm Hg (30 minutes). Treatment also included wearing a multilayered bandage until the next day. Sessions were performed consecutive days until a plateau in reduction was reached, which was normally between 10–20 sessions. Compliance with bandages was measured.

• The study sample (N = 171) was comprised of patients with breast cancer who had lymphedema.
• Median age was 60.4 years, with a range of 32–84 years.
• Patients were included in the study if they were 18 years of age or older, were free from malignant disease, and had no decongestant treatment for your year.

The study took place across multiple sites in Spain.

The study used a prospective, multicenter controlled cohort design.

• Factors associated with response were testing in a univariate and multivariate analysis using linear regression.
• Hypothesis testing was two-tailed with a 5% level of significance.
• Analyses were made with SPSS version 15.

Eleven variables were retained after initial screening. Venous insufficiency, treatment in autumn, and compliance were associated with better outcome while higher baseline excess volume and percentage reduction, heaviness, numbness, chemotherapy, axillary radiation, total dose of radiation, and treatment in winter were associated with poorer outcome.

The most important predictor of response to treatment was compliance. Early intervention is key.

• The descriptive analysis is only to identify potential risk factors.

Patient education and support to promote early intervention and patient compliance with treatment may have a positive effect in response to lymphedema treatment