A comparison of the effectiveness of complex decongestive physiotherapy and stellate ganglion block with triamcinolone administration in breast cancer-related lymphedema patients

Abstract

Purpose: This study aims to investigate the comparison of effectiveness between stellate ganglion block (SGB) and complex decongestive physiotherapy (CDT) in breast cancer-related lymphedema (BCRL) patients.

Methods: The study is a retrospective matched cohort study. A total of 60 subjects who had secondary lymphedema after breast cancer treatments were included in this study. Thirty subjects who had SGB were matched with other 30 subjects treated with CDT, which is the standard therapy for BCRL. The groups were matched for age, duration of lymphedema, type of surgery, and history of lymph node dissection. SGB subjects received SGB three times, once every 2 weeks and CDT subjects were treated for 2 weeks. The circumferences of the forearm and upper arm were used as the outcome variable. These parameters were measured with baseline value before each treatment and repeated the evaluation after the treatments. We investigated the difference of circumferences within each treatment and compared the clinical effect between treatments.

Results: Sixty subjects (mean age 58.2 ± 8.7) were treated with CDT and SGB each. There was no significant difference in demographic data including cancer treatment. The mean circumferences of the forearm and upper arm after CDT significantly reduced; forearm from 24.91 to 23.87 cm and upper arm from 30.52 to 29.58 cm (p < 0.001). And the clinical effect of SGB was also significant; forearm from 24.90 to 23.64 cm and upper arm from 30.96 to 29.16 cm (p < 0.001). The differences of the forearm between CDT and SGB was not significant, but the circumference of the upper arm was more reduced after SGB treatment (1.81 ± 1.21 cm) than CDT (0.94 cm ± 0.78 cm) (p < 0.01).

Conclusions: SGB is an effective treatment which can reduce the circumference of arm in breast cancer-related lymphedema patients and could be an alternative treatment for lymphedema.