Authors (including presenting author) :
Choi WW, So KY, Fung YK
Affiliation :
Physiotherapy Department, Tseung Kwan O Hospital
Introduction :
Breast Cancer-Related Lymphoedema (BCRL) is a common complication in patients following breast cancer surgeries that involve lymph node removal and radiation therapy. It is a chronic condition characterized by swelling due to lymphatic fluid accumulation in the arm, leading to physical discomfort and thus significantly affecting quality of life. Physiotherapy has been identified as an effective intervention to address these challenges. In 2021, the establishment of the Breast Care Center at Tseung Kwan O Hospital, along with the introduction of a Physiotherapy Lymphoedema Clinic aims to provide enhanced service and care for breast cancer survivors suffering from BCRL.
Objectives :
This study aimed to evaluate the effectiveness of a physiotherapy management program in reducing BCRL severity, measured by limb volume and L-Dex index.
Methodology :
Patients diagnosed with BCRL and referred for lymphoedema management were recruited. One-on-one treatment sessions included skin care instruction, exercise therapy, short-stretch bandaging, and manual lymphatic drainage. Education on self-management and long-term care was also provided. Patients were discharged once their condition stabilized and they demonstrated competence in self-management. Limb volume and L-Dex index were recorded during the first session and prior to discharge.
Result & Outcome :
During the review period, 61 patients were recruited, with a mean age of 63.0 ± 11.25 years. Of these, 21% had subclinical lymphoedema with normal L-Dex scores. Among the lymphoedema cases, 95.8% underwent modified radical mastectomy or axillary dissection, and 81% completed chemotherapy, while 88% received radiotherapy. The duration of lymphoedema onset ranged from 1 month to 16 years, with an average of 9 follow-up sessions. Mean volume excess (VE) between limbs reduced from 420.70 ± 572.87 ml to 319.52 ± 498.66 ml (p < 0.05), indicating a significant reduction in limb volume. L-Dex scores improved from 30.83 ± 33.18 to 18.31 ± 28.45 (p < 0.05), suggesting enhanced lymphatic function and reduced lymphoedema.
Conclusions: The findings suggest that a structured physiotherapy management program significantly reduces the severity of BCRL, as evidenced by improved limb volume and L-Dex scores. Patient compliance is crucial for treatment success. Further studies are suggested to assess additional physical outcomes, quality of life, and long-term benefits.
