Kim, J.G., Bae, S.O., & Seo, K.S. (2015). A comparison of the effectiveness of complex decongestive physiotherapy and stellate ganglion block with triamcinolone administration in breast cancer-related lymphedema patients. Supportive Care in Cancer, 23, 2305–2310.

To compare the effectiveness of a stellate ganglion block (SGB) versus complete decongestive therapy (CDT) for the treatment of lymphedema in patients with breast cancer

Medical records were used to collect data from patients with secondary lymphedema after treatment for breast cancer. Patients who received an SGB were selected, and a cohort of patients who received CDT matched by age, lymphedema duration, type of surgery, and history of lymph node dissection, which were obtained for comparison. SGBs were done three times, once every two weeks, via an injection of a lidocaine and triamcinolone mixture. Patients in the SGB group also did self-massage. In the CDT group, lymphedema measurements were taken after two weeks. In the SGB group, measurements were taken two weeks after each block was performed.

• N = 60  
• MEAN AGE = 58.2 years
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: Only unlilateral arm lymphedema cases were included. The average duration of lymphedema was 17.5 months, and the time range since mastectomy was 30–35 months. 
• OTHER KEY SAMPLE CHARACTERISTICS: All patients had chemotherapy, and most also had radiotherapy.

• SITE: Single site  
• SETTING TYPE: Outpatient    
• LOCATION: South Korea

• PHASE OF CARE: Active antitumor treatment

Retrospective cohort comparison

• Arm circumference measurements

The effects of treatments on forearm measurement were 1.03 cm and 1.26 cm for CDT and SGB, respectively. This difference was not significant. Upper arm measurements were 0.94 cm after CDT and 1.81 cm after SGB (p < 0.01). SGB-related changes were only seen after the third block. In both groups, there was a significant reduction in arm circumference after the intervention (p < 0.001).

Both CDT and serial SGBs were associated with reductions in arm lymphedema. The findings of this study showed greater reductions on average with SGBs.

• Small sample (< 100)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)

This study suggests that SGBs may be an effective alternative treatment for arm lymphedema after surgery for breast cancer. Additional research in this area is needed.