low-pressure compression corsets after mastectomy and lymphadenectomy

What is it about?

In available literature it is possible to find reports regarding the application of compression clothing for patients after breast cancer treatment, only within the scope of the upper limb on the operated side. The impetus to conduct such research was the swelling observed on most of my patients, located on the side section of the chest. A lack of reports in literature, the discomfort reported by patients, their own feelings associated with additional scarring, difficulties in selecting underwear due to the growing lymphatic fluid repository on the side of the chest became the inspiration to initiate studies. The first in Poland, was my the pilot studies regarding the application of chest post-mastectomy compression therapy.] Are compression corsets beneficial for the treatment of breast-related lymphedema?: new opportunities in physiotherapy treatment: a preliminary report. Authors: Rita Hansdorfer-Korzon, Jacek Teodorczyk, Agnieszka Gruszecka, Piotr Lass. OncoTarg. Ther. 2016; vol. 9, p. 2089-2098, ISSN: 1178-6930. The issue of lymphedema in the chest area is discussed in literature only in the event of conservative procedures (BCT- Breast Cancer Treatment), which are always associated with irradiation of the axilla, as well as the preserved breast and side section of the chest in the mid axilla line just below the mammary gland level. Most of the presented studies and publications in the area of physiotherapeutic treatment of women after mastectomy deals with and describes Complete Decongestive Therapy (CDT) only in relation to the limb on the operated side, completely disregarding the chest area, where the surgical procedure and, in the case of some patients – exclusive radiotherapy – is carried out. For every patient operated and/or irradiated due to breast cancer, there occurs at the very least a “dormant” lymphatic drainage disorder on the afflicted side, even if there is still a lack of visible edema. It is therefore discouraged to force the decongestion towards the so called “drainage barrier”.

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Why is it important?

They are not among the many available studies in literature, but they are, in my opinion, a significant and practical academic and research accomplishment, contributing new information to the subject matter of treating patients with lymphedema. Once can be hopeful in regards to their application in primary prevention of edema (compression corsets), prevention of adverse consequences of radiotherapy treatment (skin changes). It is also worth to emphasize the ultrasound method used in my studies. It is a reliable, objective, non-invasive and inexpensive tool to monitor the effects of treatment. It should be broadly used in order to increase the detection rate of subclinical stages of lymphedema and possibility of comparing treatment results among other clinical centers. It was also advisable to list the first study regarding oxidative stress as the first, in order to provide arguments as to the necessity of introducing edema prevention methods taking into consideration the threats carried by undiagnosed and untreated lymphedema. RESULTS: 1. Compression therapy using low elasticity bandages, despite its currently limited application in initial stages of lymphedema, has huge potential for the future. 2. The ultrasound method is a good, objective, repeatable and safe method to monitor physiotherapeutic progress, as well as diagnose a developing edema, and should be commonly utilized. 3. After surgical breast cancer treatment with axillary lymphadenectomy there is a risk of lymphatic fluid repository development in the side of the chest. The most likely cause, apart from individual inclinations, is a lack of treatment in order to maintain the effects achieved by MLD. 4. Class I compression corsets should constitute an integral element of comprehensive decongestive therapy. Properly selected, they are not only an effective method of lymphedema treatment, but should also be utilized in edema prevention with patients after removal of axillary lymph nodes and radiotherapy. 5. It is justified and effective to apply corsets in the reduction of pain ailments associated with surgical breast cancer treatment.

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