Manual Lymphatic Drainage for Breast Cancer-related Lymphedema: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 35370085 · doi:10.1016/j.clbc.2022.01.013
What was done
Authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) searched through April 2021 across PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov. They included trials evaluating manual lymphatic drainage (MLD) compared to a control group without MLD in women with breast cancer-related lymphedema (BCRL). Assessed outcomes included lymphedema incidence, volumetric changes, pain, and quality of life.
What was found
Across 11 RCTs with 1,564 patients (10 trials meta-analyzed), MLD showed statistically significant reductions in lymphedema incidence (RR = 0.58, 95% CI [0.37, 0.93], P = .02) and pain intensity (SMD = -0.72, 95% CI [-1.34, -0.09], P = .02). Effects on volumetric changes and quality of life were not statistically significant (no effect sizes or confidence intervals provided in the abstract).
Why it matters
This review suggests MLD may assist in preventing BCRL and alleviating pain, but does not support its efficacy for limb volume reduction or quality-of-life improvements.
Limits
The search was restricted to English-language publications. The abstract omits numerical data for non-significant outcomes (volumetric changes and quality of life), and does not report details on intervention duration, specific control treatments, or study-level risk of bias.