Effect of Manual Lymph Drainage on Breast Edema After Breast-Conserving Surgery and Radiotherapy: A Preliminary Randomized Controlled Trial

Abstract

Background/Objectives: To evaluate the effectiveness of manual lymph drainage (MLD) in treating breast edema in patients who have undergone breast-conserving surgery and adjuvant radiotherapy. Methods: Twenty-five female participants who underwent breast-conserving surgery and received adjuvant radiotherapy were enrolled in the study. Twelve participants were assigned to the treatment group (education, compression, exercise therapy, and MLD), and 13 to the control group (education, compression, and exercise therapy). The participants were assessed after radiotherapy (baseline) and three months post-treatment. The following variables were evaluated: general body pain, fatigue, breast pain, breast edema (breast edema questionnaire and LENT-SOMA-breast criteria), anxiety, depression, and quality of life. Results: In both groups, within-group analyses showed improvements in general body pain, fatigue, breast pain, breast edema, anxiety, depression, and some quality of life subscales (p < 0.05). Between-group comparisons revealed additional improvements in breast pain, breast edema, and breast-related criteria in the treatment group compared with the control group (p < 0.05). Additionally, the treatment group showed greater improvements in some quality of life subscales (global health status, fatigue, pain, systemic treatment side effects, and breast and arm symptoms) compared with the control group (p < 0.05). Conclusions: The addition of MLD may provide additional benefits within complex decongestive therapy for breast edema following breast-conserving surgery and radiotherapy. However, these findings should be considered preliminary and interpreted with caution due to the small sample size, lack of objective outcome measures, absence of a no-treatment control group, and lack of blinding of participants and treating clinicians. As both groups received active treatment during a period of expected natural recovery, the independent effect of MLD cannot be fully isolated. Confirmation in future well-designed, blinded randomized controlled trials incorporating objective outcome measures is warranted.