Lymphastim and breathing exercises in breast cancer-related lymphedema: a path to improved lung function and quality of life – a case report

Shruti N. Mankar; Bhagyashree C. Salekar; Mayura Deshmukh; Karuna  Kamble

doi:10.18203/2394-6040.ijcmph20262302

Authors

Shruti N. Mankar Department of Cardiovascular and Respiratory Physiotherapy, PES Modern College of Physiotherapy, Pune, Maharashtra, India
Bhagyashree C. Salekar Department of Musculoskeletal Physiotherapy, MAEER’s Physiotherapy College, Talegaon Dabhade, Pune, Maharashtra, India
Mayura Deshmukh Department of Cardiorespiratory Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
Karuna Kamble Department of Cardiorespiratory Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20262302

Keywords:

Breast cancer related lymphedema, Physiotherapy, Cancer rehabilitation, Mastectomy, Lymphastim

Abstract

Breast cancer incidence in India is rising, accounting for 66% of all cancers diagnosed in a year. Due to improvement in survival rates attributed to various treatment alternatives, emphasis on quality of life and secondary complications of breast cancer are of importance. Breast cancer related lymphadenopathy is a common complication in breast cancer treatment. A 76-year-old female, case of treated breast carcinoma, 5 years ago with radical mastectomy, presented with progressive, painless swelling of the left upper limb for 30 days. The swelling originated in the fingers and wrist, gradually extending proximally, restricting her functional activities. She also complained of progressive breathlessness, difficulty in doing day to day activities. Clinical examination and investigations, including arm circumference measurements, the modified Medical Research Council scale, pulmonary function tests, and the lymphedema quality of life questionnaire, confirmed significant lymphedema. The patient underwent lymphastim therapy with structured breathing exercises protocol for 4 weeks. Post-intervention assessments revealed a significant reduction in limb circumference, improved pulmonary function parameters (FEV1: 0.84 -1.06, FVC: 0.84 - 1.04), and an enhanced quality of life score (LYMQOL: 65 to 30) with relief from breathlessness and comfort in doing day to day activities. This case highlights the effectiveness of lymphastim and breathing exercises in reducing lymphedema-related morbidity and improving functional outcomes in breast cancer survivors.

References

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209-49.

Pappalardo M, Starnoni M, Franceschini G, Baccarani A, De Santis G. Breast Cancer-Related Lymphedema: Recent Updates on Diagnosis, Severity and Available Treatments. J Pers Med. 2021;11(5):402.

Zhang J, Wang C. Axillary radiotherapy: An alternative treatment option for adjuvant axillary management of breast cancer. Sci Rep. 2016;6:26304.

Lawenda BD, Mondry TE, Johnstone PA. Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA Cancer J Clin. 2009;59:8-24.

Lasinski BB, McKillip Thrift K, Squire D, Austin MK, Smith KM, Wanchai A, et al. A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011. PM R. 2012;4(8):580-601.

Fu MR, Axelrod D, Haber J. Breast-cancer-related lymphedema: information, symptoms, and risk-reduction behaviors. J Nurs Scholarsh. 2008;40:341-8.

Narahari SR, Ryan TJ. Morbidity management and disability prevention: An agenda for developing nations initiated in India. Lymphology. 2020;53(4):157-61.

Douglass J, Mableson HE, Martindale S, Kelly-Hope LA. An Enhanced Self-Care Protocol for People Affected by Moderate to Severe Lymphedema. Methods Protoc. 2019;2(3):77.