{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:06:41Z","timestamp":1784761601125,"version":"3.55.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Dokuz Eyl\u00fcl University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>The aim of this study was to demonstrate that a self-administered complex decongestive therapy (CDT) protocol is not inferior to certified lymphedema therapist (CLT)-administered CDT in the management of lymphedema and health-related outcomes in patients with breast cancer-related lymphedema (BCRL).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Fifty patients with BCRL were randomly assigned to two experimental groups: (1) a CLT-administered CDT group (<jats:italic>n<\/jats:italic>\u2009=\u200925) or a self-administered CDT group (<jats:italic>n<\/jats:italic>\u2009=\u200925). CDT was a multimodal approach in two experimental conditions consisting of patient education, manual lymph drainage, multi-layer bandaging, therapeutic exercises and skin\/nail care. Lymphedema severity was assessed using circumference measurement, and BCRL-related symptoms were assessed using a numerical rating scale. The following measurement methods were used to assess health-related outcomes: universal goniometer for range of motion (ROMs), hand grip dynamometer for peripheral muscle strength, disabilities of the arm, shoulder and hand (DASH)\u00a0questionnaire for disability level, International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity level, the checklist for individual strength (CIS) for fatigue and upper limb lymphedema quality of life questionnaire (ULL-27) for quality of life.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Following CDT, there was a significant decrease in lymphedema severity and lymphedema-related symptoms in both groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was no significant difference between the groups regarding the mean difference in health-related outcomes following CDT (post-treatment-baseline) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Lymphedema severity and symptoms remained stable during the 3-month follow-up periods in the CLT-administered CDT group (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). There was a decrease in the severity of lymphedema, stiffness, heaviness and fatigue in the self-administered CDT group at 3-month follow-up (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), while pain and tingling remained unchanged (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The present findings demonstrated self-administered CDT protocol is not inferior to CLT-administered CDT in the management of lymphedema and reduction of lymphedema-related disabilities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s10549-025-07709-3","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T17:07:13Z","timestamp":1746551233000},"page":"123-138","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Self-administered versus lymphedema therapist-administered complex decongestive therapy protocol in breast cancer-related lymphedema: a non-inferiority randomized controlled trial with three-month follow-up"],"prefix":"10.1007","volume":"212","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2919-7719","authenticated-orcid":false,"given":"Sukriye Cansu","family":"Gultekin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didem","family":"Karadibak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Burak","family":"Cakir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep Gulsum","family":"Guc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugba","family":"Yavuzsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"7709_CR1","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1002\/cncr.31840","volume":"1254","author":"L Tab\u00e1r","year":"2019","unstructured":"Tab\u00e1r L et al (2019) The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening. Cancer 1254:515\u2013523. https:\/\/doi.org\/10.1002\/cncr.31840","journal-title":"Cancer"},{"key":"7709_CR2","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/S1359-6349(03)00003-X","volume":"11","author":"GN Hortobagyi","year":"2003","unstructured":"Hortobagyi GN (2003) The curability of breast cancer: present and future. Eur J Cancer Suppl 11:24\u201334. https:\/\/doi.org\/10.1016\/S1359-6349(03)00003-X","journal-title":"Eur J Cancer Suppl"},{"key":"7709_CR3","doi-asserted-by":"publisher","first-page":"2341","DOI":"10.1200\/JCO.19.02896","volume":"3820","author":"SA McLaughlin","year":"2020","unstructured":"McLaughlin SA, Brunelle CL, Taghian A (2020) Breast cancer-related lymphedema: risk factors, screening, management, and the impact of locoregional treatment. J Clin Oncol 3820:2341\u20132350. https:\/\/doi.org\/10.1200\/JCO.19.02896","journal-title":"J Clin Oncol"},{"key":"7709_CR4","doi-asserted-by":"publisher","first-page":"2007","DOI":"10.1200\/jco.2008.18.3517","volume":"2712","author":"YC Shih","year":"2009","unstructured":"Shih YC et al (2009) Incidence, treatment costs, and complications of lymphedema after breast cancer among women of working age: a 2-year follow-up study. J Clin Oncol 2712:2007\u20132014. https:\/\/doi.org\/10.1200\/jco.2008.18.3517","journal-title":"J Clin Oncol"},{"key":"7709_CR5","unstructured":"(2020) The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology 531: 3-19"},{"key":"7709_CR6","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1089\/lrb.2024.0013","volume":"226","author":"TT Vo","year":"2024","unstructured":"Vo TT et al (2024) Effect of complex decongestive therapy program on volume and functioning in breast cancer-related lymphedema: global effect and predicting factors. Lymphat Res Biol 226:271\u2013277. https:\/\/doi.org\/10.1089\/lrb.2024.0013","journal-title":"Lymphat Res Biol"},{"key":"7709_CR7","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.31557\/apjcp.2023.24.7.2225","volume":"247","author":"S Shamoun","year":"2023","unstructured":"Shamoun S, Ahmad M (2023) Complete decongestive therapy effect on breast cancer related to lymphedema: a systemic review and meta-analysis of randomized controlled trials. Asian Pac J Cancer Prev 247:2225\u20132238. https:\/\/doi.org\/10.31557\/apjcp.2023.24.7.2225","journal-title":"Asian Pac J Cancer Prev"},{"key":"7709_CR8","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1016\/j.jpainsymman.2015.06.017","volume":"506","author":"T Gradalski","year":"2015","unstructured":"Gradalski T, Ochalek K, Kurpiewska J (2015) complex decongestive lymphatic therapy with or without vodder II manual lymph drainage in more severe chronic postmastectomy upper limb lymphedema: a randomized noninferiority prospective study. J Pain Symptom Manage 506:750\u2013757. https:\/\/doi.org\/10.1016\/j.jpainsymman.2015.06.017","journal-title":"J Pain Symptom Manage"},{"key":"7709_CR9","doi-asserted-by":"publisher","first-page":"453","DOI":"10.11124\/jbisrir-2016-003185","volume":"162","author":"E Jeffs","year":"2018","unstructured":"Jeffs E et al (2018) Clinical effectiveness of decongestive treatments on excess arm volume and patient-centered outcomes in women with early breast cancer-related arm lymphedema: a systematic review. JBI Database System Rev Implement Rep 162:453\u2013506. https:\/\/doi.org\/10.11124\/jbisrir-2016-003185","journal-title":"JBI Database System Rev Implement Rep"},{"key":"7709_CR10","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.pmrj.2012.05.003","volume":"48","author":"BB Lasinski","year":"2012","unstructured":"Lasinski BB et al (2012) A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011. Pm r 48:580\u2013601. https:\/\/doi.org\/10.1016\/j.pmrj.2012.05.003","journal-title":"Pm r"},{"key":"7709_CR11","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s12282-022-01428-z","volume":"302","author":"K Anuszkiewicz","year":"2023","unstructured":"Anuszkiewicz K, Jankau J, Kur M (2023) What do we know about treating breast-cancer-related lymphedema? Review of the current knowledge about therapeutic options. Breast Cancer 302:187\u2013199. https:\/\/doi.org\/10.1007\/s12282-022-01428-z","journal-title":"Breast Cancer"},{"key":"7709_CR12","unstructured":"(2012) Global programme to eliminate lymphatic filariasis: progress report, 2011. Weekly Epidemiol Rec 8737: 346-56"},{"key":"7709_CR13","volume-title":"Implementing cancer survivorship care planning: workshop summary","author":"PA Ganz","year":"2007","unstructured":"Ganz PA, Hewitt M (2007) Implementing cancer survivorship care planning: workshop summary. National Academies Press, Washington"},{"key":"7709_CR14","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1046\/j.1365-3156.2000.00620.x","volume":"59","author":"EA Ottesen","year":"2000","unstructured":"Ottesen EA (2000) The global programme to eliminate lymphatic filariasis. Trop Med Int Health 59:591\u2013594. https:\/\/doi.org\/10.1046\/j.1365-3156.2000.00620.x","journal-title":"Trop Med Int Health"},{"key":"7709_CR15","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12905-016-0303-9","volume":"161","author":"GR Melam","year":"2016","unstructured":"Melam GR et al (2016) Effect of complete decongestive therapy and home program on health- related quality of life in post mastectomy lymphedema patients. BMC Womens Health 161:23. https:\/\/doi.org\/10.1186\/s12905-016-0303-9","journal-title":"BMC Womens Health"},{"key":"7709_CR16","doi-asserted-by":"publisher","first-page":"102441","DOI":"10.1016\/j.eclinm.2024.102441","volume":"68","author":"HCY Wong","year":"2024","unstructured":"Wong HCY et al (2024) Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendations. clinicalmedicine 68:102441. https:\/\/doi.org\/10.1016\/j.eclinm.2024.102441","journal-title":"clinicalmedicine"},{"key":"7709_CR17","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s10549-005-3781-2","volume":"931","author":"K Didem","year":"2005","unstructured":"Didem K et al (2005) The comparison of two different physiotherapy methods in treatment of lymphedema after breast surgery. Breast Cancer Res Treat 931:49\u201354. https:\/\/doi.org\/10.1007\/s10549-005-3781-2","journal-title":"Breast Cancer Res Treat"},{"key":"7709_CR18","unstructured":"Randomization.com. [http:\/\/www.randomization.com\/]."},{"key":"7709_CR19","doi-asserted-by":"publisher","first-page":"3481","DOI":"10.1245\/s10434-014-3761-z","volume":"2111","author":"MR Fu","year":"2014","unstructured":"Fu MR et al (2014) Proactive approach to lymphedema risk reduction: a prospective study. Ann Surg Oncol 2111:3481\u20133489. https:\/\/doi.org\/10.1245\/s10434-014-3761-z","journal-title":"Ann Surg Oncol"},{"key":"7709_CR20","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1111\/j.1365-2354.1995.tb00047.x","volume":"41","author":"J Sitzia","year":"1995","unstructured":"Sitzia J (1995) Volume measurement in lymphoedema treatment: examination of formulae. Eur J Cancer Care 41:11\u201316. https:\/\/doi.org\/10.1111\/j.1365-2354.1995.tb00047.x","journal-title":"Eur J Cancer Care"},{"key":"7709_CR21","first-page":"39","volume":"29","author":"T Sithawatdecha","year":"2019","unstructured":"Sithawatdecha T, Chotiyarnwong C, Pajareya K (2019) A randomized trial of the effect of self-care booklet plus routine care compared with routine care alone in breast cancer-related lymphedema patients. ASEAN J Rehabil Med 29:39\u201344","journal-title":"ASEAN J Rehabil Med"},{"key":"7709_CR22","doi-asserted-by":"publisher","first-page":"241","DOI":"10.5306\/wjco.v5.i3.241","volume":"53","author":"MR Fu","year":"2014","unstructured":"Fu MR (2014) Breast cancer-related lymphedema: symptoms, diagnosis, risk reduction, and management. World J Clin Oncol 53:241\u2013247. https:\/\/doi.org\/10.5306\/wjco.v5.i3.241","journal-title":"World J Clin Oncol"},{"key":"7709_CR23","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1093\/ptj\/67.12.1867","volume":"6712","author":"RL Gajdosik","year":"1987","unstructured":"Gajdosik RL, Bohannon RW (1987) Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther 6712:1867\u20131872. https:\/\/doi.org\/10.1093\/ptj\/67.12.1867","journal-title":"Phys Ther"},{"key":"7709_CR24","unstructured":"Fess E, Moran C (1981) American society of hand therapists clinical assessment recommendations"},{"key":"7709_CR25","first-page":"99","volume":"17","author":"T D\u00fcger","year":"2006","unstructured":"D\u00fcger T et al (2006) Reliability and validity of the Turkish version of the disabilities of the arm, shoulder and hand (DASH) questionnaire. Fizyoterapi Rehabilitasyon 17:99\u2013107","journal-title":"Fizyoterapi Rehabilitasyon"},{"key":"7709_CR26","doi-asserted-by":"publisher","first-page":"278","DOI":"10.2466\/06.08.Pms.111.4.278-284","volume":"1111","author":"M Saglam","year":"2010","unstructured":"Saglam M et al (2010) International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills 1111:278\u2013284. https:\/\/doi.org\/10.2466\/06.08.Pms.111.4.278-284","journal-title":"Percept Mot Skills"},{"key":"7709_CR27","doi-asserted-by":"publisher","first-page":"624","DOI":"10.3109\/09593985.2011.654321","volume":"288","author":"G Ergin","year":"2012","unstructured":"Ergin G, Yildirim Y (2012) A validity and reliability study of the Turkish Checklist Individual Strength (CIS) questionnaire in musculoskeletal physical therapy patients. Physiother Theory Pract 288:624\u2013632. https:\/\/doi.org\/10.3109\/09593985.2011.654321","journal-title":"Physiother Theory Pract"},{"key":"7709_CR28","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1089\/lrb.2018.0036","volume":"181","author":"E Duygu","year":"2020","unstructured":"Duygu E, Bakar Y, Keser I (2020) An Important tool in lymphedema management: validation of Turkish version of the patient benefit index-lymphedema. Lymphat Res Biol 181:49\u201355. https:\/\/doi.org\/10.1089\/lrb.2018.0036","journal-title":"Lymphat Res Biol"},{"key":"7709_CR29","doi-asserted-by":"publisher","first-page":"455","DOI":"10.3389\/fonc.2020.00455","volume":"10","author":"A Kayali Vatansever","year":"2020","unstructured":"Kayali Vatansever A, Yavuzsen T, Karadibak D (2020) The reliability and validity of quality of life questionnaire upper limb lymphedema (ULL-27) Turkish patient with breast cancer related lymphedema. Front Oncol 10:455. https:\/\/doi.org\/10.3389\/fonc.2020.00455","journal-title":"Front Oncol"},{"key":"7709_CR30","doi-asserted-by":"crossref","unstructured":"Cohen J (1995) The earth is round (p<. 05): Rejoinder.","DOI":"10.1037\/\/0003-066X.50.12.1103"},{"key":"7709_CR31","doi-asserted-by":"publisher","first-page":"690","DOI":"10.5535\/arm.2013.37.5.690","volume":"375","author":"JM Hwang","year":"2013","unstructured":"Hwang JM et al (2013) Long-term effects of complex decongestive therapy in breast cancer patients with arm lymphedema after axillary dissection. Ann Rehabil Med 375:690\u2013697. https:\/\/doi.org\/10.5535\/arm.2013.37.5.690","journal-title":"Ann Rehabil Med"},{"key":"7709_CR32","first-page":"143","volume":"403","author":"SJ Kim","year":"2007","unstructured":"Kim SJ, Yi CH, Kwon OY (2007) Effect of complex decongestive therapy on edema and the quality of life in breast cancer patients with unilateral leymphedema. Lymphology 403:143\u2013151","journal-title":"Lymphology"},{"key":"7709_CR33","doi-asserted-by":"publisher","first-page":"347","DOI":"10.5535\/arm.2015.39.3.347","volume":"393","author":"S Noh","year":"2015","unstructured":"Noh S et al (2015) Limb Differences in the therapeutic effects of complex decongestive therapy on edema, quality of life, and satisfaction in lymphedema patients. Ann Rehabil Med 393:347\u2013359. https:\/\/doi.org\/10.5535\/arm.2015.39.3.347","journal-title":"Ann Rehabil Med"},{"key":"7709_CR34","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13561-018-0194-6","volume":"81","author":"H Schulze","year":"2018","unstructured":"Schulze H et al (2018) Worldwide assessment of healthcare personnel dealing with lymphoedema. Health Econ Rev 81:10. https:\/\/doi.org\/10.1186\/s13561-018-0194-6","journal-title":"Health Econ Rev"},{"key":"7709_CR35","doi-asserted-by":"publisher","first-page":"2344532","DOI":"10.1080\/28352610.2024.2344532","volume":"21","author":"Y Fujimoto","year":"2024","unstructured":"Fujimoto Y, Yuri Y, Tamiya H (2024) Physical function assessment scales used in rehabilitation for upper limb lymphedema: a scoping review. Cancer Survivorship Res Care 21:2344532. https:\/\/doi.org\/10.1080\/28352610.2024.2344532","journal-title":"Cancer Survivorship Res Care"},{"key":"7709_CR36","doi-asserted-by":"publisher","first-page":"e030938","DOI":"10.1136\/bmjopen-2019-030938","volume":"99","author":"J Paek","year":"2019","unstructured":"Paek J, Choi YJ (2019) Association between hand grip strength and impaired health-related quality of life in Korean cancer survivors: a cross-sectional study. BMJ Open 99:e030938. https:\/\/doi.org\/10.1136\/bmjopen-2019-030938","journal-title":"BMJ Open"},{"key":"7709_CR37","doi-asserted-by":"publisher","first-page":"211","DOI":"10.5606\/tftrd.2021.5191","volume":"672","author":"H Ye\u015fil","year":"2021","unstructured":"Ye\u015fil H et al (2021) The effects of complex decongestive therapy on kinesthetic sense of hands, upper extremity function, and quality of life in patients with breast cancer-related lymphedema. Turk J Phys Med Rehabil 672:211\u2013217. https:\/\/doi.org\/10.5606\/tftrd.2021.5191","journal-title":"Turk J Phys Med Rehabil"},{"key":"7709_CR38","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1186\/s12891-022-05780-1","volume":"231","author":"M Hemmati","year":"2022","unstructured":"Hemmati M et al (2022) The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial. BMC Musculoskelet Disord 231:837. https:\/\/doi.org\/10.1186\/s12891-022-05780-1","journal-title":"BMC Musculoskelet Disord"},{"key":"7709_CR39","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1093\/jn\/nxz268","volume":"1504","author":"SK Clinton","year":"2020","unstructured":"Clinton SK, Giovannucci EL, Hursting SD (2020) The world cancer research fund\/American institute for cancer research third expert report on diet, nutrition, physical activity, and cancer: impact and future directions. J Nutr 1504:663\u2013671. https:\/\/doi.org\/10.1093\/jn\/nxz268","journal-title":"J Nutr"},{"key":"7709_CR40","doi-asserted-by":"publisher","first-page":"3593","DOI":"10.1007\/s00520-020-05858-3","volume":"297","author":"V Yildiz Kabak","year":"2021","unstructured":"Yildiz Kabak V et al (2021) Physical activity level, exercise behavior, barriers, and preferences of patients with breast cancer-related lymphedema. Support Care Cancer 297:3593\u20133602. https:\/\/doi.org\/10.1007\/s00520-020-05858-3","journal-title":"Support Care Cancer"},{"key":"7709_CR41","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.jpsychores.2017.05.007","volume":"98","author":"M Worm-Smeitink","year":"2017","unstructured":"Worm-Smeitink M et al (2017) The assessment of fatigue: psychometric qualities and norms for the checklist individual strength. J Psycho Res 98:40\u201346. https:\/\/doi.org\/10.1016\/j.jpsychores.2017.05.007","journal-title":"J Psycho Res"},{"key":"7709_CR42","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11182568","author":"MN Mu\u00f1oz-Alcaraz","year":"2023","unstructured":"Mu\u00f1oz-Alcaraz MN et al (2023) effect of conservative rehabilitation interventions on health-related quality of life in women with upper limb lymphedema secondary to breast cancer: a systematic review. Healthcare. https:\/\/doi.org\/10.3390\/healthcare11182568","journal-title":"Healthcare"},{"key":"7709_CR43","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1080\/0284186X.2023.2213442","volume":"625","author":"KY Blom","year":"2023","unstructured":"Blom KY et al (2023) Impact on Health-Related quality of life after wearing compression garment or not for six months in women with mild breast cancer-related arm lymphedema. A Cross-Sectional Study Acta Oncologica 625:528\u2013534. https:\/\/doi.org\/10.1080\/0284186X.2023.2213442","journal-title":"A Cross-Sectional Study Acta Oncologica"},{"key":"7709_CR44","doi-asserted-by":"publisher","first-page":"003475","DOI":"10.1002\/14651858.CD003475.pub2","volume":"20155","author":"J Ezzo","year":"2015","unstructured":"Ezzo J et al (2015) Manual lymphatic drainage for lymphedema following breast cancer treatment. Cochrane Database Syst Rev 20155:003475. https:\/\/doi.org\/10.1002\/14651858.CD003475.pub2","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Breast Cancer Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-025-07709-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10549-025-07709-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-025-07709-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,18]],"date-time":"2025-05-18T07:24:08Z","timestamp":1747553048000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10549-025-07709-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":44,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["7709"],"URL":"https:\/\/doi.org\/10.1007\/s10549-025-07709-3","relation":{},"ISSN":["0167-6806","1573-7217"],"issn-type":[{"value":"0167-6806","type":"print"},{"value":"1573-7217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,6]]},"assertion":[{"value":"25 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was obtained from Dokuz Eylul University Non-Invasive Research Ethics Committee (decision number: 2023\/34-09, date: 25.10.2023).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all participants and all procedures were performed in accordance with the Declaration of Helsinki.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}