At a follow-up of 18 months, addition of a sleeve compression/exercise intervention to standard education focused on lymphedema risk reduction did not significantly decrease the incidence of lymphedema following surgery in women with early-stage breast cancer, according to results of a randomized clinical trial published in Cancer.

Lymphedema, an accumulation of lymphatic fluid in the soft tissues, is a complication of breast cancer treatments that have the potential to damage lymph nodes and vessels. In the setting of breast cancer, lymphedema typically results in a swollen arm and/or hand, and often develops gradually in the months following breast cancer treatment. It has been consistently associated with detriments in quality of life and limitations in range-of-motion (ROM) of the affected limb.

In this multicenter, phase 3 study (Cancer and Leukemia Group B [CALGB] 70305; ClinicalTrials.gov Identifier: NCT00376597), patients with newly diagnosed stage I to III breast cancer were evaluated at a preoperative visit then randomly assigned to lymphedema education (EO) or lymphedema education and prevention program (LEAP) within 6 weeks following breast surgery plus lymph node dissection. Participants in the EO group received standard lymphedema education that included self-care preventive practices from a trained lymphedema educator, with or without individualized assessment and instruction for a daily exercise regimen from a physical therapist. The LEAP group also received a 2-pound hand weight to be used each day and an elastic compression sleeve and gauntlet for use during exercise or air travel.

The primary endpoint was ­­­­­­­­­the lymphedema-free rate at 18 months, with secondary study endpoints including change in arm circumference between preoperative and 12- or 18- month postoperative visits, self-reported ROM, and adherence to use of the sleeve/gauntlet and exercises in those assigned to that study arm.

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John Mathews
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Journal of Phlebology and Lymphology
Email: phlebology@eclinicalsci.com