Edema volume, not timing, is the key to success in lymphedema treatment.

BACKGROUND There are currently between 1 and 2 million breast cancer survivors in the United States. Is the advocated, early intervention the key to successful treatment, or are there other, more important factors? METHODS Responses to combined decongestive therapy (CDT) for 69 women were analyzed with regard to duration of lymphedema, differences in arm circumference, percent differences in arm volumes, volume of edema, reduction of edema volumes, and duration of treatment. RESULTS Two- and three-dimensional (2D and 3D) analyses showed little correlation between duration and volume of edema or between duration and response and treatment. However, they did show a correlation between initial volumes of fluid in the tissues and responses. Patients with initial volumes of 250 mL or less had a mean reduction of 78% with CDT, whereas those with initial volumes between 250 and 500 mL had a mean reduction of 56%. CONCLUSION The key to predicting successful lymphedema treatment is the initial volume of edema in the tissues regardless of whether the intervention is early or late.