Lymphedema Care after Breast Cancer Surgery: Insights from a New Meta-Analysis.

BACKGROUND

Lymphedema is a common complication after breast cancer surgery that significantly affects quality of life. This study aimed to synthesize current evidence on effective interventions for lymphedema care postsurgery.

METHODS

A systematic literature search was conducted in PubMed, Cochrane Library, and Scopus to identify randomized controlled trials and observational studies published until September 2024. Included studies evaluated interventions for preventing and managing lymphedema, such as physical therapy [manual lymphatic drainage (MLD), exercise], compression therapy, and pharmacological treatments, reporting on lymphedema incidence, severity, or quality-of-life outcomes. Data were extracted by two independent reviewers, and a random-effects model estimated pooled effect sizes. Subgroup analyses were based on intervention types and design.

RESULTS

Nine studies comprising 1183 patients were included. The pooled lymphedema incidence in control groups was 22.5% [95% confidence interval (CI): 19.3%-26.1%]. MLD reduced lymphedema incidence by 38% [risk ratio (RR) = 0.62, 95% CI: 0.52-0.74], whereas compression therapy decreased limb circumference by 15% (standardized mean difference = -0.33, 95% CI: -0.46 to -0.19). Exercise programs offered a 12% risk reduction (RR = 0.88, 95% CI: 0.76-1.03). Combined interventions, such as MLD with compression garments, yielded a 44% reduction in incidence (RR = 0.56, 95% CI: 0.47-0.67) and significantly improved quality of life (mean Functional Assessment of Cancer Therapy-Breast difference = 7.4, 95% CI: 5.1-9.7). Early and integrated care approaches showed the greatest benefit.

CONCLUSIONS

This meta-analysis confirms MLD and compression therapy's effectiveness in managing postsurgical lymphedema. A multimodal approach provides optimal outcomes for reducing lymphedema burden and improving quality of life.