Intensive treatment of breast cancer-related lymphedema in patients with neurological injuries

Abstract

The aim of this study is to report on the intensive treatment of lymphedema resulting from breast cancer therapy in a 51-year-old patient who experienced loss of muscle strength of the arm. This patient developed lymphedema after a mastectomy, axillary resection, chemotherapy and radiation therapy to treat breast cancer. When the patient arrived at the Clinica Godoy for treatment in August 2012, she was evaluated using bioimpedance and volumetry before and then every day during treatment. Intensive treatment was carried out for six hours per day on three consecutive days employing Manual Lymphatic Therapy, Mechanic Lymphatic therapy (RA Godoy®) and a grosgrain compression sleeve with daily adjustments to the size. In the initial physical examination the patient reported a score for the intensity of pain of 10 (Pain Scale), paresthesia in the entire arm and there was a 577 mL difference in volume due to edema compared to the contralateral limb. On Treatment Day 1 the paresthesia was reduced using the grosgrain sleeve and Mechanical Lymphatic Therapy; on Treatment Day 2, the pain had dropped to an intensity of 7 (Pain Scale); on Treatment Day 3, the pain decreased to an intensity of 5 (Pain Scale) and the difference in the volume of edema was only 193 mL. The patient returned home but followed the recommendations and treatment program used at the clinic. Monitoring was by routine assessments and guidance on the importance of using the grosgrain sleeve and Mechanical Lymphatic Therapy to maintain the results and prevent neurological damage.