Supportive Care in Cancer

, Volume 27, Issue 10, pp 3805–3811 | Cite as

Combined decongestive therapy and reduction of pain and heaviness in patients with breast cancer-related lymphedema

  • Zahra Sheikhi Mobarakeh
  • Parisa Mokhtari-Hesari
  • Masomeh Lotfi-TokaldanyEmail author
  • Ali Montazeri
  • Mahnaz Heidari
  • Fatemeh Zekri
Original Article



We aimed to determine the effectiveness of combined decongestive therapy (CDT) and the minimum sessions required to significantly reduce pain and heaviness in patients with breast cancer-related lymphedema.


A sample of 169 patients with breast cancer-related lymphedema underwent CDT, 5 days/week for a total of 3 to 4 weeks. Self-reported pain and heaviness was quantified on a separate visual analog scale (VAS) prior to CDT and after 3, 5, 7, 10, and 15 sessions. Scores derived from VASs were categorized into three categories: mild (score < 4), moderate (score = 4–6), and severe (score > 6). Downward transition for at least one category in severity of each parameter was considered as an improvement. Repeated measure analysis of variance was conducted to test the effect of time on the severities of pain and heaviness while age, afflicted side with lymphedema, history of chemotherapy, and radiotherapy were considered as covariates.


The mean age of patients was 52.66 ± 12.20 years. In all 132 patients, out of 169 patients (71.3%) reported pain and 155 patients (83.7%) reported heaviness at baseline. However, after intervention, the cumulative percentage of patients with at least a one category reduction in pain and heaviness was 86.4% and 83%, respectively. At least seven sessions of CDT were shown to be sufficient in alleviating the severity of the symptoms in greater than 83% of patients.


The combined decongestive therapy significantly reduced the intensities of pain and heaviness in patients with breast cancer-related lymphedema.


Breast cancer Lymphedema Pain Combined decongestive therapy 


Compliance with ethical standards

The study was approved by the BCRC’s review board and the ethics committee of the Academic Center for Education, Culture and Research (ACECR). All participants completed the informed consent form.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Quality of life Department, Breast Cancer Research CenterMotamed Cancer Institute, ACECRTehranIran
  2. 2.Integrative Oncology Department, Breast Cancer Research CenterMotamed Cancer Institute, ACECRTehranIran
  3. 3.Research Department, Tehran Heart CenterTehran University of Medical SciencesTehranIran
  4. 4.Population Health Research Group, Health Metrics Research CenterIranian Institute for Health Sciences Research, ACECRTehranIran
  5. 5.Lymphedema Clinic, Breast Cancer Research CenterMotamed Cancer Institute, ACECRTehranIran

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