Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy
Journal of Surgery
Volume 4, Issue 3-1, June 2016, Pages: 14-20
Received: Jan. 31, 2016; Accepted: Jan. 31, 2016; Published: Mar. 23, 2016
Views 2819      Downloads 76
Authors
Mahmoud El-Shazly, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Wafaa Hussien Borhan, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Wael Naeem Thabet, Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
Ashraaf Hassan, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Article Tools
Follow on us
Abstract
Introduction: Post-mastectomy lymphedema is a chronic, debilitating disorder that is frequently misdiagnosed, treated too late or not treated at all, Lymphedema (LE) is an abnormal accumulation of protein-rich fluid in the interstitium leading to limb swelling, chronic inflammation and reactive fibrosis of the affected tissues resulting from damage to lymphatic circulation following surgery, chemotherapy and/or radiation therapy. The aim was to investigate the effect of shockwave therapy on the post-mastectomy lymphedema. Subjects and methods: Sixty female patients underwent modified radical mastectomy surgery or lumpectomy, chemotherapy and radiotherapy associated with unilateral lymphedema (stage 2, 3), into two equal groups; their ages ranged from 30-50 years. The study group received shockwave therapy 2 times/week for 6 weeks plus traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Control group received traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Evaluation procedures were carried out to measure the upper limb volume measurement, ROM of shoulder flexion, abduction and external rotation. Results: Post treatment results showed that there was a significant improvement difference in shoulder ROM and upper limb volume in both groups in favor of the study group. Percentage of improvement of shoulder abduction, flexion, and external rotation in the study group was 38.92%, 26.61%, 36.24% respectively, while it was 20.86%, 14.93%, 16.17%in the control group. Percentage of improvement of upper limb volume in the study group was 24.21%, while it was 15.5% in the control group. Conclusion: extracorporeal shockwave therapy was considered to be an effective modality for treatment of the post-mastectomy lymphedema.
Keywords
Lymphedema, Mastectomy, Shockwave Therapy
To cite this article
Mahmoud El-Shazly, Wafaa Hussien Borhan, Wael Naeem Thabet, Ashraaf Hassan, Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy, Journal of Surgery. Special Issue:Surgical Infections and Sepsis. Vol. 4, No. 3-1, 2016, pp. 14-20. doi: 10.11648/j.js.s.2016040301.13
Copyright
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Aly El-Din N. Cancer statistics 2002–2007. Preliminary report [online]. Available at: ; 2010 (accessed 05.09.2012).
[2]
So-Yeon Kim, MD, HasukBae, MD, Hye Min Ji, MD). A case report of ‘Computed Tomography as an Objective Measurement Tool for Secondary Lymphedema Treated With Extracorporeal Shock Wave Therapy’. Ann Rehabil Med 2015; 39(3): 488-493.
[3]
Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: a comprehensive review. Ann PlastSurg 2007; 59: 464-72.
[4]
Harris SR, et al.: "Clinical guidelines for the care and treatment of breast cancer: II Lymphedema", 2001, CMAI; 23: 1.
[5]
Rietman JS, et al., "Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer. Eur. J. Surg. Oncol. 2006; 32: 148.
[6]
Brennan MJ, De Pompolo RW, and Garden FH, "Focused review: Postmastectomy lymphedema" Arch. Phys. Med. Rehabil; 1996, 77(Suppl): S74.
[7]
Warmuth MA, et al.: "Complications of axillary lymph node dissection for carcinoma of the breast", Cancer; 1998, 83: 1362.
[8]
Richard Taylor, Upali W Jayasinghe, Louise Koelmeyer, Owen Ung and John Boyages. ‘Reliability and Validity of Arm Volume Measurements for Assessment of Lymphedema’. Journal Of The American Physical Therapy Association February 2006 vol. 86 no. 2 205-214.
[9]
Korpan MI, Crevenna R, Fialka-Moser V. Lymph¬edema: a therapeutic approach in the treatment and rehabilitation of cancer patients. Am J Phys Med Rehabil 2011; 90 (5 Suppl 1): S69-75.
[10]
Casley-Smith JR, Casley-Smith JR. Treatment of lymphedema by complex physical therapy, with and without oral and topical benzopyrones: what should therapists and patients expect. Lymphology 1996; 29: 76-82.
[11]
Williams AF, Vadgama A, Franks PJ, Mortimer PS. A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care (Engl) 2002; 11: 254-61.
[12]
HasukBae, MD, Ho Jeong Kim, MD Department of Rehabilitation Medicine, Ewha Womans University School of Medicine, Seoul, Korea. Clinical Outcomes of Extracorporeal Shock Wave Therapy in Patients with Secondary Lymphedema: A Pilot Study. Ann Rehabil Med 2013; 37(2): 229-234.
[13]
Schaden W, Thiele R, Kolpl C, Pusch M, Nissan A, Attinger CE, et al. Shock wave therapy for acute and chronic soft tissue wounds: a feasibility study. J Surg Res 2007; 143: 1-12.
[14]
Serizawa F, Ito K, Matsubara M, Sato A, Shimokawa H, Satomi S. Extracorporeal shock wave therapy in¬duces therapeutic lymphangiogenesis in a rat model of secondary lymphoedema. Eur J VascEndovascSurg 2011; 42: 254-60.
[15]
Michelini S, Failla A, Moneta G, Zinicola V, Macaluso B, Cardone M, Antonucci D: Treatment of Lymphedema with shockwave therapy: preliminary study. The European Journal of Lymphologyand related problems. 2007, 17(51): 29.
[16]
Hesham G Mahran, Ali A Thabet: “Extracorporeal Shockwave Therapy for Post-Menopausal Patients with Breast Cancer- Related Lymphedema” International Journal of Cancer Research ISSN: 2015, 2051-784X, Vol. 49, Issue. 1.
[17]
Michelini et al.: "Treatment of geriatrics lymphedema with shockwave therapy" BMC Geriatrics, 2010, 10 (Suppl 1): A105.
[18]
Serizawa, F., Ito, K., Matsubara, M., Sato, A., Shimokawa, H., & Satomi, S: Extracorporeal shock wave therapy induces therapeutic lymphangiogenesis in a rat model of secondary lymphoedema. European Journal of Vascular and Endovascular Surgery, 2011, Vol. 42, No. 2, pp. 254-260.
[19]
Rohringer S, Holnthoner W, Hackl M, Weihs AM, Ru¨nzler D, et al.: Molecular and Cellular Effects of In Vitro Shockwave Treatment on Lymphatic Endothelial Cells. PLoS ONE, 2014, 9(12): e114806. doi: 10.1371/journal.pone.0114806.
ADDRESS
Science Publishing Group
548 FASHION AVENUE
NEW YORK, NY 10018
U.S.A.
Tel: (001)347-688-8931