The treatment of lymphedema related to breast cancer: a systematic review and evidence summary.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials
PubMed 15095073 · doi:10.1007/s00520-004-0627-0
What was done
Cancer Care Ontario's Supportive Care Guidelines Group conducted a systematic review of randomized controlled trials examining treatment options for women with lymphedema following breast cancer treatment. Evidence-based recommendations were formulated and evaluated through external practitioner feedback in Ontario.
What was found
The review identified 10 randomized controlled trials. Compression therapy and manual lymphatic drainage showed evidence of benefit for established lymphedema, with daily morning-to-night compression garment use offering stabilization or modest improvement. No evidence supported medical therapies, including diuretics. The abstract reports no numerical effect sizes or quantitative outcome statistics.
Why it matters
This review establishes that physical modalities like compression garments provide modest stabilization for post-breast cancer lymphedema, while establishing a lack of evidence for routine pharmaceutical interventions like diuretics.
Limits
The abstract reports no participant counts, effect estimates, or specific primary outcome measurements from the included trials. Recommendations are restricted to patients with more than mild lymphedema, and the authors note that well-defined, standardized clinical outcome measures are still needed.
Cited by
- supports Diuretics are ineffective for treating lymphedema.