Long-term management of breast cancer-related lymphedema after intensive decongestive physiotherapy
Identifieur interne : 000482 ( France/Analysis ); précédent : 000481; suivant : 000483Long-term management of breast cancer-related lymphedema after intensive decongestive physiotherapy
Auteurs : Stéphane Vignes [France] ; Raphael Porcher [France] ; Maria Arrault [France] ; Alain Dupuy [France]Source :
- Breast cancer research and treatment [ 0167-6806 ] ; 2007.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Autosoins, Bandages, Bras (anatomopathologie), Drainage, Exercice physique, Femelle, Humains, Lymphadénectomie, Lymphoedème (), Lymphoedème (rééducation et réadaptation), Lymphoedème (étiologie), Massage, Pronostic, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Techniques de physiothérapie, Tumeurs du sein (), Études de cohortes, Études de suivi, Études longitudinales.
- MESH :
- anatomopathologie : Bras.
- rééducation et réadaptation : Lymphoedème.
- étiologie : Lymphoedème.
- Pascal (Inist)
- Adulte, Adulte d'âge moyen, Autosoins, Bandages, Drainage, Exercice physique, Femelle, Humains, Long terme, Lymphadénectomie, Lymphoedème, Massage, Pronostic, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Techniques de physiothérapie, Traitement, Conduite à tenir, Lymphoedème, Physiothérapie, Observance, Cancer du sein, Tumeurs du sein, Études de cohortes, Études de suivi, Études longitudinales.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Arm (pathology), Bandages, Breast Neoplasms (complications), Breast Neoplasms (therapy), Breast cancer, Clinical management, Cohort Studies, Compliance, Drainage, Exercise, Female, Follow-Up Studies, Humans, Long term, Longitudinal Studies, Lymph Node Excision, Lymphedema, Lymphedema (etiology), Lymphedema (rehabilitation), Lymphedema (therapy), Massage, Middle Aged, Physical Therapy Modalities, Physiotherapy, Prognosis, Self Care, Treatment, Treatment Outcome.
- MESH :
- complications : Breast Neoplasms.
- etiology : Lymphedema.
- pathology : Arm.
- rehabilitation : Lymphedema.
- therapy : Breast Neoplasms, Lymphedema.
- Adult, Aged, Aged, 80 and over, Bandages, Cohort Studies, Drainage, Exercise, Female, Follow-Up Studies, Humans, Longitudinal Studies, Lymph Node Excision, Massage, Middle Aged, Physical Therapy Modalities, Prognosis, Self Care, Treatment Outcome.
Abstract
Background Treatment of lymphedema is based on intensive decongestive physiotherapy followed by a long-term maintenance treatment. We analyzed the factors influencing lymphedema volume during maintenance treatment. Method Prospective cohort of 537 patients with secondary arm lymphedema were recruited in a single lymphology unit and followed for 12 months. Lymphedema volume was recorded prior to and at the end of intensive treatment, and at month 6 and month 12 follow-up visits. Multivariate models were fitted to analyze the respective role of the three components of complete decongestive therapy, i.e. manual lymph drainage, low stretch bandage, and elastic sleeve, on lymphedema volume during the 1-year maintenance phase therapy. Results Mean volume of lymphedema was 1,054 ± 633 ml prior and 647 ± 351 ml after intensive decongestive physiotherapy. During the 1-year maintenance phase therapy, the mean lymphedema volume slightly increased (84 ml-95% confidence interval [CI]: 56-113). Fifty-two percent of patients had their lymphedema volume increased above 10% from their value at the end of the intensive decongestive physiotherapy treatment phase. Non-compliance to low stretch bandage and elastic sleeve were risk factors for an increased lymphedema after 1-year of maintenance treatment (RR: 1.55 [95% CI: 1.3-1.76]; P < 0.0001 and RR: 1.61 (95% CI: 1.25-1.82); P = 0.002, respectively). Non-compliance to MLD was not a risk factor (RR: 0.99 [95% CI: 0.77-1.2]; P = 0.91). Conclusion During maintenance phase after intensive decongestive physiotherapy, compliance to the use of elastic sleeve and low stretch bandage should be required to stabilize lymphedema volume.
Affiliations:
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Hopital Saint-Louis AP-HP, Université Paris 7, Inserm U717</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Arrault, Maria" sort="Arrault, Maria" uniqKey="Arrault M" first="Maria" last="Arrault">Maria Arrault</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Lymphology, Hôpital Cognacq-Jay, Site Broussais, 102 rue Didot</s1><s2>75014 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>75014 Paris</wicri:noRegion><placeName><settlement type="city">Paris</settlement><region type="région" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Dupuy, Alain" sort="Dupuy, Alain" uniqKey="Dupuy A" first="Alain" last="Dupuy">Alain Dupuy</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Dermatology 2, Hôpital Saint Louis AP-HP, 1 Avenue Claude Vellefaux</s1><s2>75475 Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>75475 Paris</wicri:noRegion><placeName><settlement type="city">Paris</settlement><region type="région" nuts="2">Île-de-France</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Arm (pathology)</term><term>Bandages</term><term>Breast Neoplasms (complications)</term><term>Breast Neoplasms (therapy)</term><term>Breast cancer</term><term>Clinical management</term><term>Cohort Studies</term><term>Compliance</term><term>Drainage</term><term>Exercise</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Long term</term><term>Longitudinal Studies</term><term>Lymph Node Excision</term><term>Lymphedema</term><term>Lymphedema (etiology)</term><term>Lymphedema (rehabilitation)</term><term>Lymphedema (therapy)</term><term>Massage</term><term>Middle Aged</term><term>Physical Therapy Modalities</term><term>Physiotherapy</term><term>Prognosis</term><term>Self Care</term><term>Treatment</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Autosoins</term><term>Bandages</term><term>Bras (anatomopathologie)</term><term>Drainage</term><term>Exercice physique</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Lymphoedème ()</term><term>Lymphoedème (rééducation et réadaptation)</term><term>Lymphoedème (étiologie)</term><term>Massage</term><term>Pronostic</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Techniques de physiothérapie</term><term>Tumeurs du sein ()</term><term>Études de cohortes</term><term>Études de suivi</term><term>Études longitudinales</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Bras</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Arm</term></keywords><keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="rééducation et réadaptation" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Bandages</term><term>Cohort Studies</term><term>Drainage</term><term>Exercise</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Longitudinal Studies</term><term>Lymph Node Excision</term><term>Massage</term><term>Middle Aged</term><term>Physical Therapy Modalities</term><term>Prognosis</term><term>Self Care</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Autosoins</term><term>Bandages</term><term>Drainage</term><term>Exercice physique</term><term>Femelle</term><term>Humains</term><term>Long terme</term><term>Lymphadénectomie</term><term>Lymphoedème</term><term>Massage</term><term>Pronostic</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Techniques de physiothérapie</term><term>Traitement</term><term>Conduite à tenir</term><term>Lymphoedème</term><term>Physiothérapie</term><term>Observance</term><term>Cancer du sein</term><term>Tumeurs du sein</term><term>Études de cohortes</term><term>Études de suivi</term><term>Études longitudinales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Treatment of lymphedema is based on intensive decongestive physiotherapy followed by a long-term maintenance treatment. We analyzed the factors influencing lymphedema volume during maintenance treatment. Method Prospective cohort of 537 patients with secondary arm lymphedema were recruited in a single lymphology unit and followed for 12 months. Lymphedema volume was recorded prior to and at the end of intensive treatment, and at month 6 and month 12 follow-up visits. Multivariate models were fitted to analyze the respective role of the three components of complete decongestive therapy, i.e. manual lymph drainage, low stretch bandage, and elastic sleeve, on lymphedema volume during the 1-year maintenance phase therapy. Results Mean volume of lymphedema was 1,054 ± 633 ml prior and 647 ± 351 ml after intensive decongestive physiotherapy. During the 1-year maintenance phase therapy, the mean lymphedema volume slightly increased (84 ml-95% confidence interval [CI]: 56-113). Fifty-two percent of patients had their lymphedema volume increased above 10% from their value at the end of the intensive decongestive physiotherapy treatment phase. Non-compliance to low stretch bandage and elastic sleeve were risk factors for an increased lymphedema after 1-year of maintenance treatment (RR: 1.55 [95% CI: 1.3-1.76]; P < 0.0001 and RR: 1.61 (95% CI: 1.25-1.82); P = 0.002, respectively). Non-compliance to MLD was not a risk factor (RR: 0.99 [95% CI: 0.77-1.2]; P = 0.91). Conclusion During maintenance phase after intensive decongestive physiotherapy, compliance to the use of elastic sleeve and low stretch bandage should be required to stabilize lymphedema volume.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Vignes, Stephane" sort="Vignes, Stephane" uniqKey="Vignes S" first="Stéphane" last="Vignes">Stéphane Vignes</name></region><name sortKey="Arrault, Maria" sort="Arrault, Maria" uniqKey="Arrault M" first="Maria" last="Arrault">Maria Arrault</name><name sortKey="Dupuy, Alain" sort="Dupuy, Alain" uniqKey="Dupuy A" first="Alain" last="Dupuy">Alain Dupuy</name><name sortKey="Porcher, Raphael" sort="Porcher, Raphael" uniqKey="Porcher R" first="Raphael" last="Porcher">Raphael Porcher</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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