REVIEW – HANSDORFER-KORZON (2016)
RELEVANCE OF LOW-PRESSURE COMPRESSION CORSETS IN PHYSIOTHERAPEUTIC TREATMENT OF PATIENTS AFTER MASTECTOMY AND LYMPHADENECTOMY

This is an important paper coming from Poland that adds another piece of evidence supporting the efficacy of early intervention in the prevention of lymphedema – this time for lymphedema of the chest and torso following mastectomy and axillary node dissection.

The study group comprised 37 patients who underwent total mastectomy without breast reconstruction, all of whom had their axillary nodes removed. The study group was randomly divided into a subgroup of 19 women who received a compression corset within 1 month following surgery, and a control group of 18 women who received no therapeutical treatment for the seven-month period of observation. Some members of each group were undergoing radiotherapy during the observation period, and this offered an opportunity to observe the additional effect of radiotherapy on truncal edema, the delayed onset of radiation effects, and the salutary effects of compression corset therapy after radiotherapy treatment.

Ultrasonic skin thickness measurements were made symmetrically on both sides of the chest wall in the mid-axillary line just below the mammary gland. The ratio of the measured skin thickness for the operated and contralateral sides constituted the "thickness ratio" parameter independent of patient's hydration state, ambient temperature, seasonal influences and hormonal influences. Measurements were made at four times: baseline just prior to surgery; 1 month after surgery; 3 months after surgery; and 7 months after surgery.

There are several notable observations and conclusions arising from this seven-month trial:

When properly fitted not only are compression corsets an effective treatment for lymphedema, but also serve to prevent edema in patients who have undergone axillary nodal dissection as well as radiotherapy;

Excess fluid in the chest and torso can be reduced by moving, through manual lymph drainage, the protein-rich fluid to regions of the body with well-functioning lymphatic drainage;

Differential ultrasonic skin thickness measurement ratio between the ipsilateral and contralateral sides constitutes an effective lymphedema measurement technique for non-extremities;

Compression corsets reduce pain associated with the surgical treatment of breast cancer.

Class I corsets (vests/bras) should constitute an integral part of comprehensive therapy to prevent and combat lymph stasis (lymphedema);

Hansdorfer-Korzon R, Teodorczyk J, Gruszecka A, Wydra J and Lass P. "Relevance of low-pressure compression corsets in physiotherapeutic treatment of patients after mastectomy and lymphadenectomy" Patient Preference and Adherence 2016;(10):1177-87.

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Lymphedema Treatment is Good Business as well as Good Medicine
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