Abstract

Background: Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD) could prevent or manage limb edema in women after breast-cancer surgery.Methods: We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume.Results: In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95% confidence interval (CI) of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95% CI, -9.34 to 159.58).Conclusions: The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema.

Original languageEnglish
Article number15
JournalWorld Journal of Surgical Oncology
Volume11
DOIs
Publication statusPublished - Jan 24 2013

Fingerprint

Meta-Analysis
Drainage
Randomized Controlled Trials
Lymphedema
Edema
Databases
Confidence Intervals
Breast Neoplasms
Breast Cancer Lymphedema
Incidence
Primary Prevention
PubMed
Dissection
Arm
Language
Extremities
Odds Ratio
Therapeutics

Keywords

  • Breast cancer
  • Lymphedema
  • Manual lymph drainage
  • Meta-analysis

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

@article{e1d7e33084c54482a402d51e8998548e,
title = "Effects of manual lymphatic drainage on breast cancer-related lymphedema: A systematic review and meta-analysis of randomized controlled trials",
abstract = "Background: Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD) could prevent or manage limb edema in women after breast-cancer surgery.Methods: We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume.Results: In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95{\%} confidence interval (CI) of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95{\%} CI, -9.34 to 159.58).Conclusions: The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema.",
keywords = "Breast cancer, Lymphedema, Manual lymph drainage, Meta-analysis",
author = "Huang, {Tsai Wei} and Tseng, {Sung Hui} and Lin, {Chia Chin} and Bai, {Chyi Huey} and Chen, {Ching Shyang} and Hung, {Chin Sheng} and Wu, {Chih Hsiung} and Tam, {Ka Wai}",
year = "2013",
month = "1",
day = "24",
doi = "10.1186/1477-7819-11-15",
language = "English",
volume = "11",
journal = "World Journal of Surgical Oncology",
issn = "1477-7819",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Effects of manual lymphatic drainage on breast cancer-related lymphedema

T2 - A systematic review and meta-analysis of randomized controlled trials

AU - Huang, Tsai Wei

AU - Tseng, Sung Hui

AU - Lin, Chia Chin

AU - Bai, Chyi Huey

AU - Chen, Ching Shyang

AU - Hung, Chin Sheng

AU - Wu, Chih Hsiung

AU - Tam, Ka Wai

PY - 2013/1/24

Y1 - 2013/1/24

N2 - Background: Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD) could prevent or manage limb edema in women after breast-cancer surgery.Methods: We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume.Results: In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95% confidence interval (CI) of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95% CI, -9.34 to 159.58).Conclusions: The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema.

AB - Background: Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD) could prevent or manage limb edema in women after breast-cancer surgery.Methods: We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume.Results: In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95% confidence interval (CI) of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95% CI, -9.34 to 159.58).Conclusions: The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema.

KW - Breast cancer

KW - Lymphedema

KW - Manual lymph drainage

KW - Meta-analysis

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U2 - 10.1186/1477-7819-11-15

DO - 10.1186/1477-7819-11-15

M3 - Article

C2 - 23347817

AN - SCOPUS:84872686267

VL - 11

JO - World Journal of Surgical Oncology

JF - World Journal of Surgical Oncology

SN - 1477-7819

M1 - 15

ER -