Trial reportBMJ (Clinical research ed.)2011
Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphoedema related to breast cancer: randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02609724 (Effectiveness of Fluoroscopy-guided Manual Lymph Drainage), which is not on this map. Cited by 37 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of Fluoroscopy-guided Manual Lymph Drainage (MLD) Versus Traditional MLD or Placebo MLD, as Part of Decongestive Lymphatic Therapy, for the Treatment of Breast Cancer-related Lymphoedema (BCRL): a Randomised Controlled Trial
Who cites it
37 citing papers in PubMed, 11 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Harms of massage in persons with cancer or receiving treatment for cancer: A systematic review and meta-analysis.PloS one · 2026Pooled it
- Comparative effectiveness of non-surgical interventions and their combinations for the prevention of breast cancer-related lymphedema: a systematic review and Bayesian network meta-analysis.Frontiers in oncology · 2026Pooled it
- Comparative efficacy of various physical therapies on pain, fatigue, quality of life and functional impairment in breast cancer survivors: a network meta-analysis of randomized controlled trials.Frontiers in oncology · 2025Pooled it
- Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature.Journal of cancer survivorship : research and practice · 2021Pooled it
- Pooled it
- Exercise interventions for people undergoing multimodal cancer treatment that includes surgery.The Cochrane database of systematic reviews · 2018Pooled it
- Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment.CA: a cancer journal for clinicians · 2017Guideline
- Manual lymphatic drainage for lymphedema following breast cancer treatment.The Cochrane database of systematic reviews · 2015Pooled it
- Conservative interventions for preventing clinically detectable upper-limb lymphoedema in patients who are at risk of developing lymphoedema after breast cancer therapy.The Cochrane database of systematic reviews · 2015Pooled it
- Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer.Journal of the National Cancer Institute. Monographs · 2014Guideline
- Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials.World journal of surgical oncology · 2013Pooled it
- Are We Underestimating Breast Cancer-Related Lymphedema? The Impact of Diagnostic Thresholds and Compression Therapy.Annals of surgical oncology · 2026Trial
- Manual lymphatic drainage adds no further volume reduction to Complete Decongestive Therapy on breast cancer-related lymphoedema: a multicentre, randomised, single-blind trial.British journal of cancer · 2018Trial
- Development of an exercise intervention for the prevention of musculoskeletal shoulder problems after breast cancer treatment: the prevention of shoulder problems trial (UK PROSPER).BMC health services research · 2018Trial
- Effect of complete decongestive therapy and home program on health- related quality of life in post mastectomy lymphedema patients.BMC women's health · 2016Trial
- Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2016Trial
- Can Resistance Training Prevent Breast Cancer-Related Lymphedema? A Systematic Review with Meta-Analysis.Journal of clinical medicine · 2026Review
- The Association of Hand Dominance With the Development of Breast Cancer-related Lymphedema After Mastectomy: A Retrospective Analysis.Plastic and reconstructive surgery. Global open · 2025Article
- Prevention and Treatment of Postmastectomy Lymphedema: A Physiotherapy Perspective.Current oncology (Toronto, Ont.) · 2025Review
- Predictors of the Efficacy of Lymphedema Decongestive Therapy.Medicina (Kaunas, Lithuania) · 2025Review
Corrections and comments
- Commented on by
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the preventive effect of manual lymph drainage on the development of lymphoedema related to breast cancer.
designRandomised single blinded controlled trial.
settingUniversity Hospitals Leuven, Leuven, Belgium.
participants160 consecutive patients with breast cancer and unilateral axillary lymph node dissection. The randomisation was stratified for body mass index (BMI) and axillary irradiation and treatment allocation was concealed. Randomisation was done independently from recruitment and treatment. Baseline characteristics were comparable between the groups.
interventionFor six months the intervention group (n = 79) performed a treatment programme consisting of guidelines about the prevention of lymphoedema, exercise therapy, and manual lymph drainage. The control group (n = 81) performed the same programme without manual lymph drainage.
main outcome measuresCumulative incidence of arm lymphoedema and time to develop arm lymphoedema, defined as an increase in arm volume of 200 mL or more in the value before surgery.
resultsFour patients in the intervention group and two in the control group were lost to follow-up. At 12 months after surgery, the cumulative incidence rate for arm lymphoedema was comparable between the intervention group (24%) and control group (19%) (odds ratio 1.3, 95% confidence interval 0.6 to 2.9; P = 0.45). The time to develop arm lymphoedema was comparable between the two group during the first year after surgery (hazard ratio 1.3, 0.6 to 2.5; P = 0.49). The sample size calculation was based on a presumed odds ratio of 0.3, which is not included in the 95% confidence interval. This odds ratio was calculated as (presumed cumulative incidence of lymphoedema in intervention group/presumed cumulative incidence of no lymphoedema in intervention group)×(presumed cumulative incidence of no lymphoedema in control group/presumed cumulative incidence of lymphoedema in control group) or (10/90)×(70/30).
conclusionManual lymph drainage in addition to guidelines and exercise therapy after axillary lymph node dissection for breast cancer is unlikely to have a medium to large effect in reducing the incidence of arm lymphoedema in the short term. Trial registration Netherlands Trial Register No NTR 1055.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.