A study points to early physiotherapy, including massage and shoulder exercises, could help prevent and reduce one of the most common complications of breast cancer surgery, the secondary lymphoedema. Secondary lymphoedema  is caused by damage to the lymphatic system during treatment, leading to fluid retention and arm swelling. It affects majority of women within first year of surgery which also cause cosmetic disfigurement, anxiety, depression and emotional distress.
   The effectiveness of early physiotherapy in reducing the risk of secondary lymphedema after breast cancer surgery was investigated upon in the study.The study identified 120 women who had undergone breast cancer surgery involving removal of lymph nodes .Sixty patients were assigned to early physiotherapy and an educational strategy and 60 to the educational strategy only . Both programmes lasted three weeks and patients were followed up four weeks after surgery, and again at three, six and 12 months after surgery.
   Physiotherapy included manual lymph drainage, massage of scar tissue, and shoulder exercises by a physiotherapist. The educational strategy included materials about the lymphatic system and advice on how to avoid injury and prevent infection.One year follow-up was completed by 116 women. Of these, 18 (16%) developed secondary lymphoedema of which 14 were in the control group (25%) and four in the intervention group (7%). This difference was statistically significant.A survival analysis also showed a significant difference, with secondary lymphoedema being diagnosed four times earlier in the control group than in the intervention group.
   It was thus conluded by the researchers that early physiotherapy could help prevent and reduce secondary lymphoedema in women for at least one year after breast cancer surgery. An accompanying editorial says that physiotherapy shows promise in a selected group of women and suggests that clinicians should consider referring patients to physiotherapists who are trained in treating lymphoedema.
Source: BMJ.