Compression garments versus compression bandaging in decongestive lymphatic therapy for breast cancer-related lymphedema: a randomized controlled trial
Lymphedema as a result of curative surgery for breast cancer can lead to long-term morbidity. Decongestive lymphatic therapy (DLT) is recognized as an optimal management strategy for patients with moderate symptomatologies, but there is little data in regard to the most effective means of providing compression therapy within a DLT protocol. We conducted a randomized trial of two forms of compression therapy within the initial treatment phase of a DLT protocol for breast cancer-related lymphedema. Subjects were required to have mild–moderate lymphedema (10–40% volume difference) acquired as a result of curative breast cancer surgery and were randomized to compression bandaging or garments within the initial treatment phase of a DLT protocol. Primary endpoint was change in affected limb volume assessed via volumetry, and secondary endpoints were symptom control and upper extremity function assessed via visual analogue scales and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, respectively. Endpoints were assessed at day 10 of treatment and at 3 months and compared to baseline. Twenty-one subjects were available for analysis. The group receiving bandaging experienced greater median volume reductions at 10 days (70 vs. 5 mL; p = 0.387) and at 3 months (97.5 vs. 50 mL; p = 0.182). The bandaging group also experienced a greater increase in median DASH scores at 10 days (+20.9 vs. +5; p = 0.143) and at 3 months (+18.4 vs. +3.3; p = 0.065). Within the initial treatment phase of a DLT protocol for acquired, breast cancer-related lymphedema, compression bandaging may lead to greater volume reduction but worse upper extremity functional status (higher DASH scores) as compared to compression garments.