Physiotherapeutic methods for managing postmastectomy breast cancer–related lymphedema: a scoping review
DOI:
https://doi.org/10.37711/Keywords:
physical therapists, physical therapy modalities, breast neoplasms, mastectomy, lymphedemaAbstract
Mastectomy is the leading cause of lymphedema among breast cancer survivors, resulting in limitations in activities of daily living and a diminished quality of life. Although various physiotherapeutic methods are available for its treatment, the literature does not clearly identify which are most commonly used or how they are applied. Therefore, this review aimed to compile up-to-date evidence on the physiotherapeutic methods currently employed for the management of postmastectomy lymphedema. A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology, which is based on the framework developed by Arksey and O'Malley. Searches were performed in the following databases: BVS Regional Portal, PubMed, Web of Science, and Scopus, using MeSH terms combined with Boolean operators. A search thesaurus was developed in English, and the search focused on studies published between 2018 and 2024. A total of 759 studies were identified; 14 were reviewed in full text, and 8 were included in the final qualitative analysis. The studies were conducted in Turkey, Egypt, and the United States. Among them, 75% employed complex decongestive therapy (CDT) as the primary physiotherapeutic method for lymphedema management. In conclusion, the findings underscore the role of physiotherapists in treating postmastectomy lymphedema, with CDT emerging as the most commonly used physiotherapeutic approach—often combined with tools such as kinesiotaping, virtual reality, low- and high-compression bandaging, and negative pressure therapy.
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References
1. Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast [Internet]. 2022 [Consultado el 12 de noviembre del 2024];1;66:15-3. doi: 10.1016/j.breast.2022.08.010
2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. [Internet]. 2021 [Consultado el 12 de noviembre del 2024];71(3):209–49. doi: 10.3322/caac.21660
3. Organización Panamericana de la Salud (OPS). Cáncer de mama. 2022. [Consultado el 20 de mayo de 2025]. Disponible en: https://www.paho.org/es/temas/cancer-mama
4. Instituto Nacional de Cancerología (INC). Anuario estadístico 2021. [Internet]. 2022 [Consultado el 12 de noviembre de 2024]. Disponible en: https://www.cancer.gov.co/recursos_user/files/libros/archivos/Anuario_Estadi%CC%81sticoINC_2021.pdf
5. Instituto Nacional de Salud de Colombia (INS). Protocolo de vigilancia de cáncer de mama y cuello uterino versión 02 [Internet]. 2023 [Consultado el 12 de noviembre de 2024]. Disponible en: https://www.ins.gov.co/Direcciones/Vigilancia/sivigila/Protocolos/PRO%20Cancer%20de%20mama%20y%20cuello%20uterino.pdf
6. Correa Patiño D, Villa villareal AF, Gónima Gallego S. Características epidemiológicas de pacientes sometidas a reconstrucción mamaria: estudio de corte transversal en una institución de referencia. Rev Col Cirugía Plástica [Internet]. 2022 [Consultado el 12 de noviembre de 2024];28(2):29-36. https://www.ciplastica.com/ojs/rccp/article/view/204
7. Pereira C. Nicolás, Koshima Isao. Linfedema: actualización en el diagnóstico y tratamiento quirúrgico. Rev Chil Cir. [Internet]. 2018 [Consultado el 12 de noviembre de 2024];70(6):589-597. doi:10.4067/s0718-40262018000600589
8. Gillespie TC, Sayegh HE, Brunelle CL, Daniell KM, Taghian AG. Breast cancer-related lymphedema: risk factors, precautionary measures, and treatments. Gland Surg. [Internet]. 2018 [Consultado el 12 de noviembre de 2024];7(4):379-403. doi: 10.21037/gs.2017.11.04
9. Chappell AG, Yuksel S, Sasson DC, Wescott AB, Connor LM, Ellis MF. Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes. JPRAS Open [Internet]. 2021 [Consultado el 12 de noviembre de 2024];30:97-109. doi: 10.1016/j.jpra.2021.07.006
10. Tantawy SA, Abdelbasset WK, Nambi G, Kamel DM. Comparative Study Between the Effects of Kinesio Taping and Pressure Garment on Secondary Upper Extremity Lymphedema and Quality of Life Following Mastectomy: A Randomized Controlled Trial. Integr Cancer Ther. [Internet]. 2019 [Consultado el 12 de noviembre de 2024];18:1-10. DOI: 10.1177/1534735419847276
11. Kannan P, Lam HY, Ma TK, Lo CN, Mui TY, Tang WY. Efficacy of physical therapy interventions on quality of life and upper quadrant pain severity in women with post-mastectomy pain syndrome: a systematic review and meta-analysis. Quality of Life Research [Internet]. 2022 [Consultado el 12 de noviembre de 2024];31(4):951-73. doi: 10.1007/s11136-021-02926-x
12. Bruce J, Mazuquin B, Canaway A, Hossain A, Williamson E, Mistry P, et al. Exercise versus usual care after non-reconstructive breast cancer surgery (UK PROSPER): Multicentre randomised controlled trial and economic evaluation. The BMJ. [Internet]. 2021 [Consultado el 12 de noviembre de 2024];375:1-11. doi: 10.1136/bmj-2021-066542
13. Arksey H, O Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. [Internet]. 2005 [Consultado el 12 de noviembre de 2024];8(1):19-32.doi: 10.1080/1364557032000119616
14. Tricco AC, Lillie E, Zarin W, OBrien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. [Internet]. 2018 [Consultado el 12 de noviembre de 2024];169(7):467-73. doi: 10.7326/M18-0850
15. Lampinen R, Lee JQ, Leano J, Miaskowski C, Mastick J, Brinker L, et al. Treatment of Breast Cancer–Related Lymphedema Using Negative Pressure Massage: A Pilot Randomized Controlled Trial. Arch Phys Med Rehabil. [Internet]. 2021 [Consultado el 12 de noviembre de 2024];102(8):1465-1472.e2. doi: 10.1016/j.apmr.2021.03.022
16. Ergin G, Sahinoglu E, Karadibak D, Yavuzsen T. Effectiveness of Kinesio Taping on Anastomotic Regions in Patients with Breast Cancer-Related Lymphedema: A Randomized Controlled Pilot Study. Lymphat Res Biol. [Internet]. 2019 [Consultado el 12 de noviembre de 2024];17(6):655-60. doi: 10.1089/lrb.2019.0003
17. Atef D, Elkeblawy MM, El-Sebaie A, Abouelnaga WAI. A quasi-randomized clinical trial: virtual reality versus proprioceptive neuromuscular facilitation for postmastectomy lymphedema. J Egypt Natl Canc Inst. [Internet]. 2020 [Consultado el 12 de noviembre de 2024];32(1):1-9. doi: 10.1186/s43046-020-00041-5
18. Ozsoy-Unubol T, Sanal-Toprak C, Bahar-Ozdemir Y, Akyuz G. Efficacy of kinesio taping in early stage breast cancer associated lymphedema: a randomized single blinded study. Turkey Lymphology [Internet]. 2019 [Consultado el 12 de noviembre de 2024];52:166-76. doi:10.2458/lymph.4639
19. Askary ZM, Elshazly M. Addition of local cryotherapy for treatment of post-mastectomy lymphedema. Lymphology. [Internet]. 2022 [Consultado el 12 de noviembre de 2024];55:70-6. doi:10.2458/lymph.5269
20. Kostanoglu A, Tarakci E. Physical therapy enhances functions and quality of life in older patients with breast cancer-related lymphedema: A prospective experimental study. Niger J Clin Pract. [Internet]. 2021[Consultado el 12 de noviembre de 2024];24(3):387-92. doi: 10.4103/njcp.njcp_373_19
21. Duygu-Yildiz E, Bakar Y, Hizal M. The effect of complex decongestive physiotherapy applied with different compression pressures on skin and subcutaneous tissue thickness in individuals with breast cancer-related lymphedema: a double-blinded randomized comparison trial. Supportive Care in Cancer. [Internet]. 2023 [Consultado el 12 de noviembre de 2024];31(7):1-12. doi: 10.1007/s00520-023-07843-y
22. Ozcan DS, Dalyan M, Unsal Delialioglu S, Duzlu U, Polat CS, Koseoglu BF. Complex Decongestive Therapy Enhances Upper Limb Functions in Patients with Breast Cancer-Related Lymphedema. Lymphat Res Biol. [Internet]. 2018 [Consultado el 12 de noviembre de 2024];16(5):446-52. doi: 10.1089/lrb.2017.0061
23. Rodríguez Manso M, Martín Mourelle R, Otero Villaverde S, Canosa Hermida E. Manejo del linfedema secundario a cáncer de mama empleando terapia descongestiva compleja con presoterapia multicompartimental secuencial. Experiencias en una unidad de linfedema. Rehabilitacion [Internet]. 2018 [Consultado el 12 de noviembre de 2024];52(4):216-22. doi: 10.1016/j.rh.2018.04.004
24. Zuther Joachim E. Lymphedema Management: the comprehensive guide for practitioners. Second edition. Stuttgart: Thieme Books [Internet]. 2009. Disponible en: https://www.thieme-connect.de/products/ebooks/lookinside/10.1055/b-0034-74684
25. Cruz Ramos JA, Cedeño Meza A, Bernal Gallardo JA, Mora Jiménez E de la, Cervantes Cardona GA, Rivas Rivera F. Efecto de terapia descongestiva compleja en linfedema secundario al tratamiento quirúrgico y calidad de vida en mujeres con cáncer de mama. Salud & Sociedad [Internet]. 2018 [Consultado el 12 de noviembre de 2024];9(1):88-96. doi: 10.22199/S07187475.2018.0001.00005
26. Internacional Society of lymphology. The diagnosis and treatment of peripheral lymphedema: 2016 Consensus Document of the International Society of lymphology. Lymphology [Internet]. 2016 [Consultado el 12 de noviembre de 2024];49(4):170-84. https://pubmed.ncbi.nlm.nih.gov/29908550/
27. Michopoulos E, Papathanasiou G, Vasilopoulos G, Polikandrioti M, Dimakakos E. Effectiveness and Safety of Complete Decongestive Therapy of Phase I: A Lymphedema Treatment Study in the Greek Population. Cureus [Internet]. 2020 [Consultado el 12 de noviembre de 2024];12(7). doi: 10.7759/cureus.9264
28. Borman P, Yaman A, Yasrebi S, Pinar Ínanli A, Arikan Donmez A. Combined Complete Decongestive Therapy Reduces Volume and Improves Quality of Life and Functional Status in Patients With Breast Cancer-Related Lymphedema. Clin Breast Cancer [Internet]. 2022 [Consultado el 12 de noviembre de 2024];22(3):e270-7. doi: https://doi.org/10.1016/j.clbc.2021.08.005
29. Brandão ML, Soares HPDS, Andrade MDA, Faria ALS de C, Pires RS. Efficacy of complex decongestive therapy for lymphedema of the lower limbs: a systematic review. J Vasc Bras [Internet]. 2020 [Consultado el 12 de noviembre de 2024];19:1-6. doi: 10.1590/1677-5449.190074.
30. Aguirre-Carvajal M, Marchant-Pérez P. Descripción del efecto de los ejercicios de la extremidad superior ipsilateral realizados con realidad virtual en mujeres sometidas a mastectomía. Gaceta Mexicana de Oncología. [Internet]. 2015 [Consultado el 12 de noviembre de 2024];14(4):204-9. doi: 10.1016/j.gamo.2015.10.002
31. Zasadzka E, Pieczynska A, Trzmiel T, Hojan K. Virtual Reality as a Promising Tool Supporting Oncological Treatment in Breast Cancer. International Journal of Environmental Research and Public Health [Internet]. 2021 [Consultado el 12 de noviembre de 2024];18(16):8768. doi: 10.3390/ijerph18168768
32. Rodrigues-Oliveira HK, Goncalves E, Dal-Pont GC, Valvassori SS, Pacheco R. Benefícios da facilitacão neuromuscular proprioceptiva em mulheres mastectomizadas: um estudo piloto. Inova Saúde. [Internet]. 2016 [Consultado el 12 de noviembre de 2024];5(2):1-15. doi:10.18616/is.v5i2.3008
33. Kandasoglu H, Unsal Delialioglu S. Adherence to complete decongestive therapy in patients with postmastectomy lymphedema and related factors. Turk J Phys Med Rehabil [Internet]. 2024 [Consultado el 12 de noviembre de 2024];70(2):204-211. doi: 10.5606/tftrd.2024.12178
34. Kasawara KT, Mapa JMR, Ferreira V, Added MAN, Shiwa SR, Carvas N Jr, Batista PA. Effects of Kinesio Taping on breast cancer-related lymphedema: A meta-analysis in clinical trials. Physiother Theory Pract [Internet]. 2018 [Consultado el 12 de noviembre de 2024];34(5):337-345. doi: 10.1080/09593985.2017.1419522
35. Marotta N, Lippi L, Ammendolia V, Calafiore D, Inzitari MT, Pinto M, et al. Efficacy of kinesio taping on upper limb volume reduction in patients with breast cancer-related lymphedema: a systematic review of randomized controlled trials. Eur J Phys Rehabil Med [Internet]. 2023 [Consultado el 12 de noviembre de 2024];59(2):237–47. doi: 10.23736/S1973-9087.23.07752-3
36. Ersoy S, Kesiktas N, Sirin B, Bugdayci ND, Kibar H, Paker N. Comparison of manual lymphatic drainage massage and negative pressure massage therapy efficacy in lymphedema patients: a randomized controlled study. The European Research Journal [Internet]. 2023 [Consultado el 12 de noviembre de 2024];9(6):1474-82. doi:10.18621/eurj.1354942
37. Olmos Torres EP. Crioterapia: Dos modalidades Terapéuticas para la rehabilitación del linfedema. Revista Venezolana de Oncología [Internet]. 2020 [Consultado el 12 de noviembre de 2024];32(4):216-222. https://www.redalyc.org/articulo.oa?id=37566335100
38. Kavak SK, Unver G. Effect of complex decongestive therapy on frailty and quality of life in women with breast cancer-related lymphedema: the before-and-after treatment study. Front. Oncol. [Internet]. 2024 [Consultado el 12 de noviembre de 2024];14:1297074. doi: 10.3389/fonc.2024.1297074
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Copyright (c) 2025 Harold Andrés Payán Salcedo, Nancy Natalia Malpud Malpud , Jenly Karoline Piamba Lozano, Mariana Marín Lorez, Florencio Arias Coronel

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