Li, L., Yuan, L., Chen, X., Wang, Q., Tian, J., Yang, K., & Zhou, E. (2016). Current treatments for breast cancer-related lymphoedema: A systematic review. Asian Pacific Journal of Cancer Prevention, 17, 4875–4883.
DOI Link
Purpose
STUDY PURPOSE: To summarize the effects of different breast cancer–related lymphedema (BCRL) treatments
TYPE OF STUDY: Systematic review
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 14
- TOTAL PATIENTS INCLUDED IN REVIEW: Unknown
- SAMPLE RANGE ACROSS STUDIES: Complex decongestive therapy (CDT), manual lymphatic drainage (MLD), intermittent pneumatic compression, exercise, botanicals, low-level laser therapy (LLLT), surgery, weight reduction, stem cells, Kinesio Tex Tape (KTT), acupuncture
Phase of Care and Clinical Applications
PHASE OF CARE: Multiple phases of care
APPLICATIONS: Elder care
Results
- CDT needs comparisons.
- MLD was deemed safe (60%–80% of participants reported feeling better).
- Exercise appeared to have no effect on lymphedema.
- Insufficient evidence for the use of botanicals
- LLLT demonstrated greater reductions, but sample sizes were small (8–64), for a total of 289.
- Modern surgery has a role in management.
- KTT is no more effective than usual care.
- Acupuncture appears to be safe but lacks evidence.
Conclusions
Based on the study limitations, the most effective treatment for BCRL could not be identified, because of varying quality and small sample sizes with high risk of bias. Different treatments for BCRL might reduce volume, but effects and well designed randomized, controlled trials with reported placebo effects are needed.
Limitations
- Mostly low quality/high risk of bias studies
- Low sample sizes
- This review lacked a large number of studies in all the interventions reviewed.
Nursing Implications
CDT remains the standard of care for the treatment of lymphedema. Complementary therapies may be safe, but more well designed randomized, controlled trials are needed.