Effect of Complex Decongestive Therapy on Quality of Life in Advanced Breast Cancer Patients With Upper Limb Lymphedema: A Quasi-Experimental Study From a Palliative Lymphedema Care Clinic in Bangladesh.

BACKGROUND AND AIM: Lymphedema is a frequent and debilitating complication of advanced breast cancer that significantly impairs physical, psychological, and functional well-being. Complex Decongestive Therapy (CDT) is considered the gold standard of conservative treatment, yet evidence from resource-limited settings such as Bangladesh remains scarce. To evaluate the effect of CDT on limb volume reduction and quality of life (QOL) among women with advanced breast cancer presenting with upper limb lymphedema in a palliative care setting in Bangladesh.

METHODS

This quasi-experimental study was conducted at the Palliative Lymphedema Care Clinic of a tertiary care hospital, between May 2023 to September 2023. Forty-two women with stage III-IV breast cancer and unilateral upper limb lymphedema were included. The patients received a standard 6-week CDT protocol, administered under the supervision of palliative care specialists in the clinic. Limb volume was measured using the circumference method, and QOL was assessed using the validated Bengali version of the Lymphedema Life Impact Scale (LLIS). Data were analyzed using paired t-test, ANOVA, and Pearson correlation.

RESULTS

The mean age of participants was 50.2 years; most had stage IV cancer (54.8%) and ECOG performance status III (71.4%). After 6 weeks of CDT, limb volume significantly decreased (right arm: 2492.4 → 1586.4 cm³; left arm: 3505.6 → 1630.0 cm³; p = 0.001). LLIS scores improved significantly across physical, psychosocial, and functional domains (p < 0.001). Greater QOL improvements were observed among patients with ECOG III compared to ECOG IV (p = 0.019). Reduction in limb volume correlated moderately with improvements in physical and functional concerns as well as overall QOL.

CONCLUSION

CDT effectively reduces limb volume and enhances QOL among advanced breast cancer patients with lymphedema. Timely initiation of CDT in palliative settings may maximize benefits, underscoring the importance of integrating structured lymphedema management within cancer care in Bangladesh.