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A randomized study to prevent lymphedema in women treated for breast cancer: CALGB 70305 (Alliance)
- Source :
- Cancer
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Background Lymphedema affects many women who are treated for breast cancer. We examined the effectiveness of an education-only (EO) versus education plus sleeve compression/exercise intervention (lymphedema education and prevention [LEAP]) on lymphedema incidence and range of motion (ROM) in a group-randomized trial across 38 cooperative group sites. Methods The treating institution was randomly assigned to either EO or LEAP by a study statistician. All patients at a treating institution participated in the same intervention (EO or LEAP) to minimize contamination bias. Participants completed surveys, arm volume measurements, and self-reported ROM assessments before surgery and at 12 and 18 months after surgery. Lymphedema was defined as a ≥10% difference in limb volume at any time post-surgery up to 18 months after surgery or diagnosis by a health provider. Cochran-Mantel-Haenszel tests were used to compare lymphedema-free rates between groups, stratified by lymph node surgery type. Self-reported ROM differences were compared between groups. Results A total of 554 participants (56% LEAP) were included in the analyses. At 18 months, lymphedema-free rates were 58% (EO) versus 55% (LEAP) (P = .37). ROM for both arms was greater in LEAP versus EO at 12 months; by 18 months, most women reported full ROM, regardless of group. In LEAP, only one-third wore a sleeve ≥75% of the time; 50% performed lymphedema exercises at least weekly. Conclusion Lymphedema incidence did not differ by intervention group at 18 months. Poor adherence in the LEAP group may have contributed. However, physical therapy may speed recovery of ROM. Further research is needed to effectively reduce the incidence and severity of lymphedema in patients who have breast cancer.
- Subjects :
- Adult
Cancer Research
medicine.medical_specialty
Breast Neoplasms
Article
law.invention
Poor adherence
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Breast cancer
Randomized controlled trial
law
Early Medical Intervention
Humans
Medicine
Cooperative group
Lymphedema
030212 general & internal medicine
Range of Motion, Articular
Mastectomy
Aged
Aged, 80 and over
business.industry
Incidence
Incidence (epidemiology)
Middle Aged
Hand
medicine.disease
humanities
Exercise Therapy
body regions
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
Arm
Physical therapy
Lymph Node Excision
Female
Self Report
business
Range of motion
Healthcare providers
Follow-Up Studies
Subjects
Details
- ISSN :
- 10970142 and 0008543X
- Volume :
- 127
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....6bf3afd0d88932c0d0c11a94a3a7801b