Clinical treatment of arm lymphedema in an outpatient setting: Two years of follow up

The aim of this study is to report on a multidisciplinary outpatient approach to the clinical treatment of lymphedema adapting the conditions of an existing work. The reduction in breast-cancer related lymphedema over two years was evaluated in a retrospective study for a group of 31 women with ages ranging between 35 and 83 years old (mean 56.6 years) in the Godoy Clinic in Sao Jose do Rio Preto. The treatment involved manual lymph drainage using the Godoy & Godoy technique, active and passive exercises utilizing facilitating apparatuses designed for these patients, a home-made compression sleeve made of a cotton-polyester fabric, nutritional guidance, psychological support, guidance about occupational activities (day-to-day activities, work and handicraft activities) and directed hydrogymnastics. Constant readjustments were made to the compression sleeves by a professional seamstress. Monthly evaluations were made by water-displacement volumetry. Analysis of variance was employed for statistical analysis with an alpha level of 5% (p-value < 0.05) being considered acceptable. The mean reduction in the first year was 55.2% and in the second year it was 75.8%, respectively, both of which were statistically significant (p-value < 0.001). Significant reduction of breast-cancer related lymphedema and maintenance of the results is possible, however routine check-ups and guidance should continue for periods determined by the treatment team.