Ultrasound evaluation of therapeutic effects of complex decongestive therapy in secondary lymphedema due to breast cancer

Introduction/Background Lymphedema due to breast surgery affects 20–25% of patients treated with lymphadenectomy. Most studies on lymphedema and ultrasound are based on the use of ultrasound as a diagnostic method, but not as a method for treatment evaluation. Objective To evaluate by ultrasound the effect of complex decongestive therapy(CDT) in patients with lymphedema after lymphadenectomy due to breast surgery. Material and method Prospective study from February to September 2016. The sample consists of 12 patients with lymphedema treated with CDT during 5 weeks. Circumferences in both, affected and unaffected limb, were measured with measuring tape. Thickness of subcutaneous tissue and compliance were measured by ultrasound at 7 and 14 cm above the elbow, and 7 and 14 cm below. Compliance is calculated: (thickness without pressure − thickness with maximal pressure)/thickness without pressure. All three measurements, circumference, thickness and compliance, were made before and after treatment. Data analysis of means. Means compared using t -Student and non-parametric tests. Statistical significance was set at P Results After treatment, significant improvements were found on the resultant difference of the circumferences measurements, between affected and unaffected limb, decreasing from 7.92 ± 2.91 to 3.83 ± 3.16 ( P  = 0.00). Resultant difference of the thickness also appeared significantly improved, from 0.77 ± 0.35 to 0.37 ± 0.20 ( P  = 0.002). Compliance slightly increased in all measurements on affected limb. No significant changes in compliance were found either at the affected not at the unaffected side. Conclusion Ultrasonic thickness measurement could be a good tool for evaluating the therapeutic effects of TDC, but further studies are needed with larger sized sample.