Response of Skin Thickness in Cases of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy

Background: Post-mastectomy lymphedema may occur early after surgery or chemotherapy and may be take months to appear. It is a condition in which fluid and protein accumulate in the extravascular interstitial spaces. Lymphedema leading to several skin changes as fibrosis and hyperkeratosis in skin creases.The aim was to investigate the effect of shockwave therapy on the skin sickness in cases of the post-mastectomy lymphedema.Subjects and Methods: Sixty female patients underwent modified radical mastectomy surgery or lumpectomy, chemotherapy and radiotherapy associated with unilateral lymphedema (stage 2 and 3) were classified into two equal groups, their ages ranged from 30-50 years. The study group received shockwave therapy 2 times/week for 6 weeks plus traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times/week/6weeks. Control group received traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3 times/week/6 weeks. Evaluation procedures were carried out to measure the skin thickness at most fibrotic point by using ultrasonography.Results: Post treatment results showed that there was a significant decrease in skin thickness in Group A with percentage of improvement 22.51%. But there was insignificant decrease in skin thickness in Group B with percentage of improvement 1.28%.Conclusion: Extracorporeal shockwave therapy is considered to be an effective modality for decreasing skin thickness in cases of post-mastectomy lymphedema.