Effects of 4-Week Complex Decongestive Therapy in the Management of Breast Cancer Arm Lymphedema in Montenegrin Women Post-Mastectomy and Chemo-/Radiotherapy

Objectives: This study aimed to assess the effects of complete decongestive therapy (CDT) on reducing lymphedema, enhancing gross motor strength (GMS), functional ability in the upper arm, quality of life (QoL), and pain relief in women who have undergone breast cancer surgery and chemo-/radiotherapy in Montenegro. Methods: The observational study included 50 women with breast cancer-related arm lymphedema, with an average age of 60.88 ± 12.78 years. The four-week Phase1-CDT program involved manual lymphatic drainage, compression bandaging, skin care, tailored kinesitherapy and patient education. Measurements included arm edema circumference compared to the contralateral arm, pain severity (VAS), arm muscle strength (MMT), functional ability (QDASH) and overall QoL (WHOQOL-BREF). Re-sults: Following CDT, there were significant reductions in lymphedema circumference in various areas and overall (p=0.002), along with improvements in overall upper arm GMS (p=0.002) and specific upper extremity movements like wrist and forearm flexion, supination, and external rotation (p< 0.001). Pain severity and QDASH score also showed significant improvements (p< 0.001), and overall QoL significantly increased (p< 0.001). Muscle strength in the hand, wrist, forearm and shoulder also improved significantly (p< 0.05). The study found a negative correlation between edema size and motor function in different muscle groups of the upper extremity, as well as between the QDASH score, quality of life and overall upper arm gross motor strength. Conclusions: The four-week CDT program had a significant positive impact on Montenegrin women with breast cancer who had undergone mastectomy and chemo/radiotherapy. The program effectively reduced lymphedema severity, improved functional abilities, gross motor strength and overall quality of life, while also reducing pain levels.