Extracorporeal shock wave therapy as a potential therapeutic tool for breast cancer related lymphedema: a narrative review of in vitro, animal and clinical studies

Background: The treatment of breast cancer related lymphedema (BCRL) focuses on the alleviation symptoms. One of the innovative, non-invasive therapies used for this condition is extracorporeal shock wave therapy (ESWT). Aim of the study: To review the available literature and evaluate the effectiveness of ESWT in the treatment of secondary lymphedema (in vitro works, animal experiments) and lymphedema associated with the treatment of breast cancer. Material and methods: The scientific literature review was conducted from October to December 2020. The review was carried out by searching scientifically recognized medical databases, including PubMed, MEDLINE and PEDro. Date restrictions were not applied. As there are only a few clinical studies assessing the effectiveness of ESWT on the reduction of lymphedema, case reports, animal experiments and in vitro works were included in the review. Articles written in a language other than English were excluded. Results: In total, the analysis included twelve studies, including seven clinical trials, one case report, three animal experiments and one in vitro test.Conclusions: Based on the results of the analyzed articles, ESWT can be an effective therapeutic tool for lymphedema occurring after breast cancer treatment. Unfortunately, the level of evidence is relatively weak since the number of publications on this subject is still quite low. The accumulated results indicate the need for further clinical trials.