Liao, S.F., Li, S.H., Huang, H.Y., Chen, S.T., Kuo, S.J., Chen, D.R., & Wei, T.S. (2013). The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of lymphedema severity and response to CDP in breast cancer-related lymphedema (BCRL). Breast, 22, 703–706.

To estimate the efficacy of and predictive factors for response to complete decongestive physical (CDP) therapy in women with breast cancer-related lymphedema

Retrospective review of records was done to describe results of a CDP program and analyze factors that might predict outcomes and CDP response. The CDP program consisted of 10–26 sessions of manual lymph drainage, compression therapy for 23 hours per day, remedial exercise, and skin and nail care instructions.

• The sample consisted of 107 female patients with breast cancer.
• Mean age of the sample was 52.8 years with a range of 26–74 years.
• Eighty-eight percent of the patients had modified radical mastectomy (all but one had axillary lymph node excision), and 64.5% had radiation therapy.
• Average duration of lymphedema was 22.4 months, and average baseline excess volume was 504. 

The study was conducted at a single-site, outpatient setting in Taiwan.

Patients were undergoing mutliple treatment phases of care.

 The study used a retrospective, observational design.

• Arm circumference measures were used to determine arm volume.
• Arm volume difference of at least 5% was defined as lymphedema.
   

• Post CDP, lymphedema volume decreased 226 ml (SD = 129 ml, range 790, -30).
• Baseline lymphedema severity and younger age were correlated with better response to CDP.
• Type of surgery and radiotherapy were not significantly correlated with lymphedema severity or CDP response.

 Findings suggest that baseline lymphedema and age are significantly related to longer-term response to CDP for lymphedema management.

• The study had no control group or binding and was not randomized.
• Other interventions that may have been used that could affect results were not described.
• The study was a retrospective design. 
• No information was given about compliance with compression bandaging.

This study provides little new information regarding efficacy of CDP in management of lymphedema in women with breast cancer. Findings show that initial severity of lymphedema may predict response to CDP, which suggests that early intervention for lymphedema can be important.