Protocol for Randomized Controlled Trial Investigating the Efficacy of Extracorporeal Shockwave Therapy Versus Complex Decongestive Therapy in Breast Cancer Survivors

This protocol describes a randomized comparative study to evaluate the effectiveness of complex decongestive therapy (CDT) combined with intermittent pneumatic compression therapy (IPCT) versus extracorporeal shock wave therapy (ESWT) in women with postmastectomy lymphedema.Eligible participants will be allocated to either the CDT+ IPCT group or the ESWT group, with both groups also receiving remedial exercises.Primary outcomes will include changes in limb girth, hand circumference, and grip strength, while secondary outcomes will assess shoulder pain and disability, quality of life and chemotherapy induced polyneuropathy symptoms using SPADI, FACT-B, and FACT-GOG NTx scales respectively.This study aims to address a critical gap in the literature by directly comparing these comprehensive rehabilitation strategies, with the goal of identifying optimal, accessible, and holistic approaches for improving physical function and quality of life in breast cancer survivors with lymphedema.