Low level laser therapy (photobiomodulation) for the management of breast cancer-related lymphedema: an update

Breast cancer related lymphedema (BCRL) is prevalent among breast cancer survivors, and may be painful and disfiguring with associated psychological impact. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy for managing BCRL, in countries including the United States and Australia. However, conclusions were limited by the paucity, heterogeneity, and poor quality of previous studies. LLLT (PBM) has been barely used in clinical practice in New Zealand, and no clinical studies on LLLT (PBM) for BCRL have been conducted in this country. In order to promote this potentially useful treatment modality for BCRL patients, the Laser Lymphedema Trial Team at the University of Otago conducted a program to assess the effectiveness of LLLT (PBM) in management of BCRL. The program comprises three phases including a systematic review (completed), a feasibility study (completed), and a full-scale randomized controlled trial (proposed). This current paper provides an update on the program. Based upon the systematic review, LLLT (PBM) is considered a potentially effective treatment approach for women with BCRL; the review also indicated the need for further research including exploration of the relevance of dosage and other LLLT (PBM) parameters. The feasibility study demonstrated that it is feasible to conduct a fully powered RCT to definitively test the effectiveness of the additional use of LLLT (PBM) in the management of BCRL, and 114 participants will be needed at baseline in the main study. Currently, the full-scale RCT is under preparation.

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