Lymphedema pp 287-293 | Cite as

Upper Limb Lymphedema

  • Robert J. Damstra


Within the realm of lymphatic disease treatment, there are many therapeutic interventions available, as highlighted in previous chapters. Treatment of lymphedema (LE) is very challenging. Therapeutic options in LE include conservative and operative modalities and should be individualized with regard to the circumstances of the patient and the lymphedema by a multidisciplinary approach. These circumstances include age, comorbidities, prognosis of (malignant) disease, psychosocial aspects, and physical potential. The goals for conservative treatment are to eliminate edema by reducing interstitial fluid accumulation and to stimulate lymphatic propulsion by compression.


Volume Reduction Intermittent Pneumatic Compression Interface Pressure Compression Therapy Manual Lymph Drainage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Rockson SG, Miller LT, Senie R, brennan MJ, et al. American Cancer Society lymphedema workshop. Workgroup III: diagnosis and management of lymphedema. Cancer. 1998;83(12 suppl American):2882-2885.PubMedCrossRefGoogle Scholar
  2. 2.
    Damstra RJ, Kaandorp C. Multidisciplinary guidelines for early diagnosis and management. J Lymphoedema. 2006;1(1):37-65.Google Scholar
  3. 3.
    International Lymphoedema Framework. Best Practice for the Management of Lymphedema. International Consensus. London: MEP Ltd; 2006:1-60.Google Scholar
  4. 4.
    Shaw C, Mortimer PS, Judd PA. Randomized controlled trial comparing a low-fat diet with a weight-reduction diet in breast cancer-related lymphedema. Cancer. 2007;109(10):1949-1956.PubMedCrossRefGoogle Scholar
  5. 5.
    Meeske KA, Sullivan-Halley J, Ashley W, et al. Risk factors for arm lymphedema following breast cancer diagnosis in Black women and White women. Breast Cancer Res Treat. 2009;113(2):383-391.PubMedCrossRefGoogle Scholar
  6. 6.
    Petrek JA, senie RT, peters M, Rosen PP. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001;92(6):1368-1377.PubMedCrossRefGoogle Scholar
  7. 7.
    Pain SJ, Purushotham AD, Barber RW, Ballinger JR, et al. Variation in lymphatic function may predispose to development of breast cancer-related lymphoedema. Eur J Surg Oncol. 2004;30(5):508-514.PubMedCrossRefGoogle Scholar
  8. 8.
    Andersen L, Hojris I, Erlandsen M, Andersen J. Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage: a randomized study. Acta Oncol. 2000;39(3):399-405.PubMedCrossRefGoogle Scholar
  9. 9.
    Johansson K, Albertsson M, Ingvar C, Ekdahl C. Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema. Lymphology. 1999;32(3):103-110; Comment in: Lymphology. 2000;33:69-70.PubMedGoogle Scholar
  10. 10.
    Korpon MI, Vacuriu G, Schneider B. Effects of compression therapy in patients after breast cancer surgery. Annual Congresses of the American College of Phlebology. San Diego, California, 2003; Online (Annual Meeting Abstracts).
  11. 11.
    Kligman L, Wong RKC, Johnston M, Laetsch NS. The treatment of lymphedema related to breast cancer: a systematic review and evidence summary. Support Care Cancer. 2004;12(6):421-431.PubMedCrossRefGoogle Scholar
  12. 12.
    Yamamoto R, Yamanoto T. Effectiveness of the treatment-phase of two-phase complex decongestive physiotherapy for the treatment of extremity lymphedema. Int J Clin Oncol. 2007;12(6):463-468.PubMedCrossRefGoogle Scholar
  13. 13.
    Moseley AL, Carrati CJ, Piller NB. A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol. 2007;18(4):639-646.PubMedCrossRefGoogle Scholar
  14. 14.
    Hamner JB, Fleming MD. Lymphedema therapy reduces the volume of edema and pain in patients with breast cancer. Ann Surg Oncol. 2007;14(6):1904-1908.PubMedCrossRefGoogle Scholar
  15. 15.
    Badger CM, Peacock JL, Mortimer PS. A randomized, controlled, parallel-group clinical trial comparing multilayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Cancer. 2000;88(12):2832-2837.PubMedCrossRefGoogle Scholar
  16. 16.
    Johansson K, Lie E, Ekdahl C, Lindfeldt J. A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Lymphology. 1998;31:56-64.PubMedGoogle Scholar
  17. 17.
    Swedborg I. Effects of treatment with an elastic sleeve and intermittent pneumatic compression in post-mastectomy patients with lymphoedema of the arm. Scand J Rehabil Med. 1984;16:35-41.PubMedGoogle Scholar
  18. 18.
    Vignes S, Porcher R, Arrault M, Dupuy A. Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy. Support Care Cancer. 2010. doi:  10.1007/s00520-010-0906-x.
  19. 19.
    Modi S, Stanton AWB, Svensson WE, Peters A, Mortimer PS, Levick JR. Human lymphatic pumping measured in healthy and lymphedematous arms by lymphatic congestion lymphoscintigraphy. J Physiol. 2007;583(Pt 1):271-285.PubMedCrossRefGoogle Scholar
  20. 20.
    Partsch H, Clark M, Mosti G, et al. Classification of compression bandages: practical aspects. Dermatol Surg. 2008;34(5):600-609.PubMedCrossRefGoogle Scholar
  21. 21.
    Damstra RJ, Partsch H. Compression therapy in breast cancer related lymphedema. A randomized controlled, comparative study of relation between volume and interface pressure changes. J Vasc Surg. 2009;49:1256-1263.PubMedCrossRefGoogle Scholar
  22. 22.
    Brorson H, Svensson H. Complete reduction of lymphoedema of the arm by liposuction after breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1997;31:137-143.PubMedCrossRefGoogle Scholar
  23. 23.
    Damstra RJ, Voesten HGJ, Klinkert P, Brorson H. Reduction surgery by Circumferential Suction-Assisted Lipectomy (Brorson method) in end stage breast cancer-related lymphedema: a prospective study. Br J Surg. 2009;96(8):859-864.PubMedCrossRefGoogle Scholar
  24. 24.
    Brorson H, Ohlin K, Olsson G, Nilsson M. Adipose tissue dominates chronic arm lymphedema following breast cancer: an analysis using volume rendered CT images. Lymphat Res Biol. 2006;4:199-210.PubMedCrossRefGoogle Scholar
  25. 25.
    Megens A, Harris SR. Physical therapist management of lymphedema following treatment for breast cancer: a critical review of its effectiveness. Phys Ther. 1998;78(12):1302-1311.PubMedGoogle Scholar
  26. 26.
    Lymphoedema Framework. Template for Practice: Compression Hosiery in Lymphoedema. London: MEP Ltd; 2006.Google Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  • Robert J. Damstra
    • 1
  1. 1.Department of Dermatology, Phlebology and Lympho-Vascular MedicineNij Smellinghe HospitalDrachtenThe Netherlands

Personalised recommendations