University of Surrey

Test tubes in the lab Research in the ATI Dance Research

The clinical effectiveness of decongestive treatments on excess arm volume and patient centered outcomes when provided within 12 months of developing a swollen arm for women with breast cancer-related lymphedema: a systematic review

Jeffs, E, Ream, Emma, Taylor, Cath and Bick, D (2017) The clinical effectiveness of decongestive treatments on excess arm volume and patient centered outcomes when provided within 12 months of developing a swollen arm for women with breast cancer-related lymphedema: a systematic review JBI Database of Systematic Reviews and Implementation Reports.

[img] Text
JBISRIR-2016- 003185_R3 (1)_22july17a.pdf - Accepted version Manuscript
Restricted to Repository staff only

Download (2MB)

Abstract

Background

Lymphedema is a common consequence of breast cancer treatment requiring life-long treatment to reduce symptoms and prevent complications. Evidence to inform the optimal decongestive lymphedema treatment package is lacking.

Objective

To identify the effect of decongestive lymphedema treatment on excess arm volume or patient-centered outcomes for women presenting within either 12 months or mean 9 months of developing arm lymphedema following breast cancer treatment.

Inclusion criteria

Types of participants: women who received lymphedema treatment within either 12 months or mean 9 months of developing unilateral breast cancer-related arm lymphedema. Types of intervention: any decongestive lymphedema treatment delivered with the purpose of reducing arm lymphedema, compared to another form of lymphedema treatment (whether self or practitioner administered), placebo or no treatment. Types of outcomes: clinical outcome was excess arm volume; patient-centered outcomes were health related quality of life, arm heaviness, arm function, patient-perceived benefit and satisfaction with treatment. Types of studies: experimental study designs were eligible, including randomized and non-randomized controlled trials, quasi-experimental, prospective and retrospective before and after studies.

Search strategy

A three-step search strategy was utilized to find published and unpublished studies. The search identified studies published from inception of each database to 6th July 2016. Reference lists were scanned to identify further eligible studies.

Methodological quality

Studies were critically appraised using appropriate standardized critical appraisal instruments from The Joanna Briggs Institute.

Data extraction

Details describing each study and treatment results regarding outcomes of interest were extracted from papers included in the review using appropriate standardized data extraction tools from The Joanna Briggs Institute.

Data synthesis

Due to heterogeneity in included studies, results for similar outcome measures were not pooled in statistical meta-analysis. A narrative and tabular format was used to synthesize results from identified and included studies.

Results

Seven studies reporting results for outcomes of interest were critically appraised and included in the review: five randomized controlled trials and two descriptive (uncontrolled) studies. Reported outcomes included excess arm volume (five studies), health-related quality of life (three studies), arm heaviness (one study), arm function (two studies) and patient-perceived benefit (two studies). There was some evidence that decongestive treatments were effective for women presenting within either 12 months or mean 9 months of developing breast cancer-related arm lymphedema, but the wide range of data prevented comparison of treatment findings which limited our ability to answer the review questions.

Conclusions

Weak evidence (grade B) for the impact of decongestive lymphedema treatment on women with early lymphedema (i.e. less than 12 months duration of BCRL symptoms) did not allow any conclusions to be drawn about the most effective treatment to be offered when these women first present for treatment. Findings provided no justification to support change to current practice. Future primary research needs to focus on the most effective treatment for women when they first present with lymphedema symptoms, e.g. treatment provided within 12 months of developing symptoms. Studies should be adequately powered and recruit women exclusively with less than 12 months duration of BCRL symptoms, provide longer follow-up to monitor treatment effect over time, with comparable treatment protocols, outcome measures and reporting methods.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Jeffs, EUNSPECIFIEDUNSPECIFIED
Ream, Emmae.ream@surrey.ac.ukUNSPECIFIED
Taylor, Cathcath.taylor@surrey.ac.ukUNSPECIFIED
Bick, DUNSPECIFIEDUNSPECIFIED
Date : 25 December 2017
Copyright Disclaimer : Copyright 2017 Lippincott, Williams & Wilkins
Uncontrolled Keywords : lymphedema; breast cancer; decongestive lymphedema treatment (DLT).
Depositing User : Melanie Hughes
Date Deposited : 25 Oct 2017 12:09
Last Modified : 25 Oct 2017 12:14
URI: http://epubs.surrey.ac.uk/id/eprint/842664

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year


Information about this web site

© The University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.
+44 (0)1483 300800