Self-administration of complex decongestive therapy facilitated by the mobile application WeChat improves lymphedema and quality of life in breast cancer survivors: an observational study

Xu Liang; Miaoning You; Cuiju Wen; Fengzhen Hou; Jingjing Kang; Zhihua Lv; Jun Tian

doi:10.21037/atm-21-6662

Self-administration of complex decongestive therapy facilitated by the mobile application WeChat improves lymphedema and quality of life in breast cancer survivors: an observational study

Ann Transl Med. 2022 Feb;10(3):146. doi: 10.21037/atm-21-6662.

Authors

Xu Liang^#¹, Miaoning You^#¹, Cuiju Wen^#², Fengzhen Hou³, Jingjing Kang¹, Zhihua Lv¹, Jun Tian¹

Affiliations

¹ Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
² Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Cancer Prevention and Treatment Center, Peking University Cancer Hospital & Institute, Beijing, China.
³ School of Science, China Pharmaceutical University, Nanjing, China.

^# Contributed equally.

Abstract

Background: Lymphedema is the most common complication of breast cancer patients. Complex decongestive therapy (CDT) is often recommended but the efficacy varies due to the complexity of management. This study investigated a novel model of CDT based on a mobile application with the aim of improving the management of lymphedema in China.

Methods: We developed a novel model of CDT for breast cancer survivors with lymphedema, including 5 days of CDT therapy with training provided by medical staff in the outpatient clinic and 3 weeks of self-administrated CDT with daily online instructions during phase I, and a life-long maintenance treatment with online instructions once a week for phase II, which delivered by WeChat public accounts. The breast cancer and lymphedema symptom experience index (BCLE-SEI) and the Short-Form Health Survey (SF-36) were used to assess lymphatic symptoms and quality of life. Arm volume and lymphatic symptoms were assessed at baseline, and at 5 days, 1 month, and 3 months post-treatment. The quality of life was assessed at baseline and at 3 months post-treatment.

Results: A total of 88 patients with lymphedema were recruited, of whom, 61 followed the protocols and were further analyzed for this study. The mean relative excess arm volume (EAV) was reduced from a baseline value of 30.72% to 22.05%, 18.46%, and 16.67% at 5 days, 1 month, and 3 months post-therapy, respectively (P=0.000). The BCLE-SEI scores of lymphatic pain, heaviness, and impaired limb mobility were all significantly improved after 3 months of treatment (P<0.05). Moreover, according to the subscale of SF-36, the general health and vitality were significantly improved after 3 months of therapy (56.64 vs. 62.93, P=0.008; and 64.26 vs. 70.08, P=0.024, respectively).

Conclusions: The proposed model of CDT based on the mobile application WeChat achieved promising outcomes. The volume of the affected arm, the lymphedema symptoms, and the quality of life were all significantly improved.

Keywords: Breast cancer; complex decongestive therapy (CDT); lymphedema; self-administered.