Prevention and Treatment of Postmastectomy Lymphedema: A Physiotherapy Perspective

Lymphedema is a frequent complication associated with breast cancer treatment. It is estimated that up to 30% of patients undergoing mastectomy develop this condition within 12 to 24 months post-surgery. In Mexico, the limited emphasis placed on lymphedema prevention in breast cancer patients is reflected in the insufficient coverage of this issue within official medical guidelines. In this review, research articles, systematic reviews, and official treatment guidelines were retrieved from PubMed, Google Scholar, Elsevier, SciELO, and Redalyc databases, to examine studies about the application and effectiveness of physiotherapy techniques for the prevention, diagnosis, and treatment of postmastectomy lymphedema. Our findings indicate that complex decongestive therapy (CDT) is considered the first-line treatment for lymphedema. Among its components, compression therapy shows the strongest individual evidence base. Nevertheless, studies consistently demonstrate that the combined use of all four components of CDT (manual lymphatic drainage, compression, skin care, and exercise) results in superior patient outcomes. Despite this, CDT is not routinely implemented as a standard of care for patients following mastectomy and/or lymphadenectomy in Mexico. Therefore, there is a pressing need to promote the inclusion of physiotherapy strategies, particularly CDT, in the prevention and management of postmastectomy lymphedema within national healthcare protocols.