The Significance of Renewing Intensive Lymph Therapy Courses in the Prevention of Exacerbation and Recurrence of Breast Cancer Related Lymphedema (BCRL)

Introduction: The current prevailing approach for managing BCRL is complete decongestive therapy (CDT), beginning with intensive therapy, followed by ongoing maintenance treatment for the patient. Maintenance treatment alone is not enough to meet the long-term needs of patients. Materials and Methods: A cross-sectional single-group interventional study was conducted from October ۲۰۱۹ to February ۲۰۲۱ on ۵۷ women diagnosed with BCRL referred to Iranian Cancer Control Center (MACSA), for the provision of palliative supportive services. Limb circumference measurements and assessments of patients' quality of life (QoL) were conducted on two separate occasions: before and one month after the treatment was finished using two questionnaires, the QLQ-C۳۰ and QLQ-BR۲۳. The participants were reevaluated after a ۶-month period using the same research procedures. Results: The results of the ۶-month after care, showed that a significant proportion (۶۲%) of the patients experienced an increase in limb circumference, particularly around the elbow. Only ۹% of patients showed a larger decrease in size compared to the measurements taken one month after intensive phase. Additionally, ۲۵% of patients experienced a decline in their overall QoL during the ۶-month follow-up period, compared to the one-month follow-up. The pain level remained constant in ۴۷% of patients, while in ۵۲% of patients, the pain not only did not decrease, but actually intensified. Conclusions: The follow-up of lymphedema patients through maintenance treatment alone, such as exercise, the use of special gloves, skin care, and self-lymphatic massage, is insufficient. It is recommended that patients be encouraged to refer to lymphedema clinics for comprehensive decongestion courses in order to prevent worsening of lymphedema and maintain a stable quality of life. Regular rechecks should be conducted at shorter intervals, such as every ۳ to ۴ months.

کلیدواژه ها:

Breast Cancer ، Breast Cancer Related Lymphedema ، Quality of Life ، Palliative Supportive Care ، After Care