Background: Breast cancer-related lymphedema (BCRL) of the upper extremities often
follows breast cancer treatment. Although complex decongestive therapy (CDT) is currently
the standard treatment for BCRL, stellate ganglion block (SGB) has also been reported to be
effective.
Objectives: This study aimed to determine the effectiveness of SGB in the treatment of
BCRL, and to assess the impact of the treatment on the quality of life (QoL) compared to
CDT.
Study Design: A randomized controlled trial.
Setting: A single academic hospital, outpatient setting.
Methods: A total of 38 patients with BCRL were recruited. Patients were randomly divided
into 2 groups. Patients enrolled in the CDT group underwent 10 sessions of CDT for 2 weeks,
whereas patients in the SGB group received 3 consecutive SGBs every 2 weeks. Changes in
circumference, volume, and bioimpedance in the upper extremity were measured at baseline
and 2 weeks after treatment and compared between the 2 groups. EuroQol-5 dimensions
(EQ-5D) and EuroQol visual analog scale (EQ VAS) for QoL and subjective improvement were
monitored.
Results: In both groups, side-to-side difference of circumference after the treatment was
decreased significantly from baseline (P < 0.05), and side-to-side difference of volume was
reduced significantly in the SGB group (P < 0.05). No statistically significant difference was
noted in the treatment effect between the 2 groups. Results of the EQ-5D, EQ VAS, and
questionnaires regarding subjective symptoms administered at baseline and 2 weeks after
each intervention revealed no statistically significant difference in the treatment effects
between CDT and SGB.
Limitations: Further long-term follow-up studies with a greater number of patients that
include analysis according to the severity and duration of symptoms are needed.
Conclusions: The results of this study suggest that SGB is an effective treatment for BCRL
and may be considered as an alternative to CDT.
Key words: Stellate ganglion block, complex decongestive therapy, breast cancer,
lymphedema, breast cancer-related lymphedema, quality of life, bioimpedance, secondary
lymphedema