Shortwave diathermy in the management of chronic lymphedema following breast cancer surgery: proof-of-concept findings from a single-arm, pre-post, retrospective observational study

Background: Chronic lymphedema of the upper limb is a frequent and disabling consequence of breast cancer surgery. It is associated with swelling and reduced quality of life. While manual lymphatic drainage is a standard treatment, additional physical modalities have shown potential to enhance therapeutic outcomes. This study aimed to evaluate the effects of short-wave diathermy combined with manual lymphatic drainage on limb circumferential measurements and quality of life in women with chronic lymphedema following breast cancer surgery. Methods: This single-arm, pre-post, retrospective observational study included twenty female patients treated between January 2023 and January 2025. All participants received nine sessions of short-wave diathermy over four weeks, followed by manual lymphatic drainage, with concurrent compression therapy as per routine care. Limb circumference was measured at nine anatomical sites before and after treatment. Quality of life was assessed using the Italian version of the Lymphedema Quality of Life Questionnaire. Statistical analysis was performed using paired t-tests. Results: Significant reductions in limb circumference were observed at seven of the nine measurement sites (P<0.05), particularly in the mid and proximal forearm and upper arm. The mean baseline overall score on the Lymphedema Quality of Life Questionnaire was 7.8, indicating moderate to severe impact. No adverse events were reported during the treatment period. Conclusions: Short-wave diathermy combined with manual lymphatic drainage appears to be a safe and effective adjunctive treatment for chronic upper limb lymphedema in breast cancer survivors. These findings support its integration into multidisciplinary rehabilitation programs.