Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, Prieto Merino D, Mayoral del Moral O, Cerezo Téllez E, Minayo Mogollón E, et al.
BMJ (Clinical research ed.). Date of publication 2010 Jan 12;volume 340():b5396.
1. BMJ. 2010 Jan 12;340:b5396. doi: 10.1136/bmj.b5396.
Effectiveness of early physiotherapy to prevent lymphoedema after surgery for
breast cancer: randomised, single blinded, clinical trial.
Torres Lacomba M(1), Yuste Sánchez MJ, Zapico Goñi A, Prieto Merino D, Mayoral
del Moral O, Cerezo Téllez E, Minayo Mogollón E.
Author information:
(1)Physiotherapy Department, School of Physiotherapy, Alcalá de Henares
University, E-28871 Alcalá de Henares, Madrid, Spain. maria.torres@uah.es
Comment in
BMJ. 2010;340:b5235.
J Physiother. 2010;56(2):134.
OBJECTIVE: To determine the effectiveness of early physiotherapy in reducing the
risk of secondary lymphoedema after surgery for breast cancer.
DESIGN: Randomised, single blinded, clinical trial.
SETTING: University hospital in Alcalá de Henares, Madrid, Spain.
PARTICIPANTS: 120 women who had breast surgery involving dissection of axillary
lymph nodes between May 2005 and June 2007.
INTERVENTION: The early physiotherapy group was treated by a physiotherapist with
a physiotherapy programme including manual lymph drainage, massage of scar
tissue, and progressive active and action assisted shoulder exercises. This group
also received an educational strategy. The control group received the educational
strategy only.
MAIN OUTCOME MEASURE: Incidence of clinically significant secondary lymphoedema
(>2 cm increase in arm circumference measured at two adjacent points compared
with the non-affected arm).
RESULTS: 116 women completed the one year follow-up. Of these, 18 developed
secondary lymphoedema (16%): 14 in the control group (25%) and four in the
intervention group (7%). The difference was significant (P=0.01); risk ratio 0.28
(95% confidence interval 0.10 to 0.79). A survival analysis showed a significant
difference, with secondary lymphoedema being diagnosed four times earlier in the
control group than in the intervention group (intervention/control, hazard ratio
0.26, 95% confidence interval 0.09 to 0.79).
CONCLUSION: Early physiotherapy could be an effective intervention in the
prevention of secondary lymphoedema in women for at least one year after surgery
for breast cancer involving dissection of axillary lymph nodes.
TRIAL REGISTRATION: Current controlled trials ISRCTN95870846.
DOI: 10.1136/bmj.b5396
PMCID: PMC2806631
PMID: 20068255 [Indexed for MEDLINE]
