By John Otrompke
CHICAGO -- November 5, 2009 -- Daily massage of an arm affected by lymphoedema after treatment for breast cancer results in reduced swelling in the arm but does not appear to improve arm function, according to early results from a multicentre randomised trial presented here at the American Society of Therapeutic Radiology and Oncology (ASTRO) 51st Annual Meeting.
Benefit from massage treatment appears modest compared with treatment by immediate elastic compression sleeve alone, according to Ian Dayes, MD, McMaster University, Hamilton, Ontario, and colleagues.
"Looking at arm-function data, no difference was seen between the groups," said Dr. Dayes on November 3. He continued, "It was a bit of a surprise; maybe the questions we were asking just were not specific enough."
In the study, 103 patients who had previously received treatment for breast cancer were enrolled from 6 institutions and randomised to receive either the sleeve or 4 weeks of daily 1-hour manual decongestive therapy followed by arm bandaging. The massage therapy was given Monday through Friday.
After treatment, patients in the massage group showed a 29.8% decrease in excess arm volume, compared with 22.6% in the group that received the sleeve, for a difference of 7.13%.
Treatment by sleeve is considered to be more conservative, Dayes said. "The sleeve is easier to put on and requires no special training. We paid about $250 for the sleeve versus $1,500 for the massage."
Other factors such as quality of life, measured by the Short Form (SF)-36 questionnaire, and arm function, measured by DASH, showed similar results.
"The SF-36 tool included questions about shortness of breath or going up a flight of stairs; maybe they were not relevant to lymphoedema," he suggested. The DASH tool looked at the patient's ability to balance a textbook, open a jar of jam, dial a phone, or type, for example.
The researchers also looked at a patient's degree of pain. "We might just need to look at each individual question," said Dr. Dayes.
According to the researchers, the study may also have been skewed by the fact that 8 patients dropped out of the study, 7 of whom had been randomised to the sleeve-alone arm.
[Presentation title: DELTA: A Randomized Trial of Decongestive Lymphatic Therapy for Women With Lymphedema Following Treatment for Breast Cancer. Abstract 112]
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