Low-energy Extracorporeal Shock Wave Therapy (ESWT) on secondary fibrolymphedema
Breast cancer diagnosis and treatment with sentinel lymph node biopsy, axillary lymph node dissection and (neo)adjuvant radiotherapy can cause secondary lymphedema. Studies between 2007 and 2011 reported an overall incidence of 20% 6 months post-surgery, about 2,000 diagnoses/year in Belgium. The accumulation of protein rich fluid in the interstitial tissue, chronic inflammation of the lymphatic channels and fat hypertrophy lead to a clinical lymphedema, if untreated to a fibrolymphedema. Management of secondary lymphedema to improve QoL includes up to date regular exercise, combined physical therapy (CPT), compression bandages, derivative and reconstructive surgery (LVA, LNT, Liposuction) and the prevention of infections.