Managing Postmastectomy Lymphedema with Low-Level Laser Therapy
Rufina W.L. Lau, M.Sc., and Gladys L.Y. Cheing, Ph.D.
Photomedicine and Laser Surgery Volume 27, Number 5, 2009
Objective: We aimed to investigate the effects of low-level laser therapy (LLLT) in managing postmastectomy lymphedema. Background Data: Postmastectomy lymphedema (PML) is a common complication of breast cancer treatment that causes various symptoms, functional impairment, or even psychosocial morbidity. A prospective, single-blinded, controlled clinical trial was conducted to examine the effectiveness of LLLT on managing PML.
Background: Twenty-one women suffering from unilateral PML were randomly allocated to re- ceive either 12 sessions of LLLT in 4 wk (the laser group) or no laser irradiation (the control group). Volumetry and tonometry were used to monitor arm volume and tissue resistance; the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire was used for measuring subjective symptoms. Outcome measures were assessed before and after the treatment period and at the 4 wk follow-up.
Results: The results revealed that 75% of the patients reported a reduction in pain in the same session after laser treatment, and total regression of the lesion occurred after 4 days. Total regression in the corticoid group was from 5 to 7 days.
Conclusion: Reduction in arm volume and increase in tissue softening was found in the laser group only. At the follow-up session, significant between-group differences (all p < 0.05) were found in arm volume and tissue resistance at the anterior torso and forearm region. The laser group had a 16% reduction in the arm volume at the end of the treatment period, that dropped to 28% in the follow-up. Moreover, the laser group demonstrated a cumulative increase from 15% to 33% in the tonometry readings over the forearm and anterior torso. The DASH score of the laser group showed progres- sive improvement over time. Conclusion: LLLT was effective in the management of PML, and the effects were maintained to the 4 wk follow-up.