Prevention and treatment of secondary lymphedema of the arm in breast cancer patients
A program of early postoperative rehabilitation (kinesy therapy and education) has been conducted since 1996 in our Department for Rehabilitation at the Institute of Oncology in Sremska Kamenica. The aim of this program is to prevent the appearance of secondary lymphedema of the arm and the contacture of the shoulder. Unless the patient, in further follow up, does not have any complication, a program of "late" rehabilitation is conducted. If secondary lymphedema of the arm (SLEA) is evolved, then the patient is submitted to a complex of decongestive physical therapy (CDP) or CDP and sequential pneumatic compression (SEPC). However if SLEA and local alterations on the skin exist, we immobilize the arm (mitela, plaster). In other cases without SLEA, e.g. periarthritis or the damage of brachial plexus, we perform physical procedures (kinesy therapy TENS, kryo-massage and acupuncture). With regard to the degree of complication of SLEA and consequences that might develop the starting point should be directed towards early detection of SLEA.