To examine the impact of advanced practice nurse (APN) administered low level laser therapy (LLLT) as both a stand-alone and complementary treatment for arm volume, symptoms, and quality of life (QOL) in women with breast cancer related lymphedema.

A three-group, pilot, randomized clinical trial.

A private rehabilitation practice with two locations in the southwestern United States.

46 breast cancer survivors with treatment related lymphedema.

Patients were screened for eligibility and then randomized to either manual lymphatic drainage (MLD) for 40 minutes, LLLT for 20 minutes, or, 20 minutes of MLD followed by 20 minutes of LLLT. Compression bandaging was applied after each treatment. Data were collected pre-treatment, daily, weekly, and at the end of treatment.

Independent variables consisted of three types of APN administered lymphedema treatment. Outcome variables included limb volume, extracellular fluid, psychological and physical symptoms, and QOL.

No statistically significant between group differences were found in volume reduction; however, all groups had clinically and statistically significant reduction in volume. No group differences were noted in psychological and physical symptoms, or QOL; however, treatment related improvements were noted in symptom burden within all groups. Skin improvement was noted in each group that received LLLT.


LLLT with bandaging may offer a time saving therapeutic option to conventional MLD. Alternatively compression bandaging alone could account for the demonstrated volume reduction.

Implications for Nursing

APNs can effectively treat lymphedema. APNs in private healthcare practices can serve as valuable research collaborators.