A new study has reported that decongestive therapy (massage by a trained therapist) for breast cancer-related arm lymphedema is most effective if it takes place before the lymphedema becomes well established. Previous studies have reported benefits of decongestive treatment in patients with lymphedema, but few have evaluated factors predictive of response. The study included 171 patients with lymphedema with median age 60.4 years and duration of lymphedema averaging four years. Percentage reduction in excess arm volume was the primary measure used to evaluate the effectiveness of the therapy. Arm volumes were measured before and at the end of decongestive treatment. At baseline, average excess volume was 936 mL and average percentage excess volume was 35.3%. Compliance to bandages was good in 81.3% of the study participants.

Percentage reduction in excess arm volume was found to be 71.7% overall as a result of decongestive treatment. Four variables were found to be independent predictors of response to treatment: venous insufficiency; percentage of excess volume (the higher the original excess volume, the lower the reduction in volume resulting from decongestive treatment); compliance to bandages (good compliance improved percentage reduction in excess volume); and treatment in the fall (better results than during other seasons). The authors conclude that compliance to bandages during decongestive treatment is one of the most important predictors of response. In addition, more severe lymphedema has a less favorable response to decongestive treatment, indicating that such therapy should be recommended in early stages.