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Reduction of breast lymphoedema secondary to breast cancer: a randomised controlled exercise trial

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Abstract

Background

Breast lymphoedema can occur following surgical treatment for breast cancer. We investigated whether an exercise program reduced breast lymphoedema symptoms compared to a non-exercise control group.

Methods

A single-blinded randomised controlled trial was conducted in which women with stable breast lymphoedema (n = 89) were randomised into an exercise (n = 41) or control (n = 47) group. The intervention comprised a 12-week combined aerobic and resistance training program, supervised weekly by an accredited exercise physiologist. All participants completed a weekly symptoms diary and were assessed monthly to ensure that there was no exacerbation of their lymphoedema. Changes in the breast were captured physically with ultrasound and bioimpedance spectroscopy and changes in symptoms were captured using European Organization for Research and Treatment of Cancer (EORTC) Breast Cancer (BR23) and Lymphoedema Symptom Intensity and Distress questionnaires.

Results

The exercise group reported a greater reduction in breast-related symptoms than the control group, assessed by the EORTC BR23 breast symptom questions. Measures of extracellular fluid, assessed with bioimpedance spectroscopy ratio, decreased in the exercise group compared to the control group. No significant difference was detected in dermal thickness in the breast, assessed by ultrasound. Session attendance in the exercise sessions was high, with two musculoskeletal adverse events reported, but no exacerbations of lymphoedema observed.

Conclusion

Combined resistance and aerobic exercise training is safe for women living with breast lymphoedema. Preliminary data suggest exercise training can reduce breast lymphoedema symptoms to a greater extent than usual care.

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Data availability

The datasets from the current study are available from the corresponding author on reasonable request.

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Funding

This research is supported by a National Health and Medical Research Grant (APP1021608).

Author information

Authors and Affiliations

  1. Sydney School of Health Sciences, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia

    S. L. Kilbreath, G. M. Davis, D. A. Hackett & D. Black

  2. School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia

    L. C. Ward

  3. Department of Surgery, Mayo Clinic, Rochester, MN, USA

    A. C. Degnim

  4. School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia

    T. L. Skinner

Authors
  1. S. L. Kilbreath
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  2. L. C. Ward
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  3. G. M. Davis
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  4. A. C. Degnim
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  5. D. A. Hackett
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  6. T. L. Skinner
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  7. D. Black
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Corresponding author

Correspondence to S. L. Kilbreath.

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Conflict of interest

Author B consults to ImpediMed Ltd., a manufacturer of impedance devices. ImpediMed Ltd. was not involved in the conceptualisation, design or execution of this study, nor in any preparation of the manuscript. Authors A, C, D, E, F and G have no conflicts of interest to report.

Ethical approval

All procedures performed in this study involving human participants were conducted in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards and approved by Royal Prince Alfred Hospital Human Ethics Review Committee (Reference Number X12-0144 & HREC/12/RPAH/239).

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Kilbreath, S.L., Ward, L.C., Davis, G.M. et al. Reduction of breast lymphoedema secondary to breast cancer: a randomised controlled exercise trial. Breast Cancer Res Treat 184, 459–467 (2020). https://doi.org/10.1007/s10549-020-05863-4

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  • DOI: https://doi.org/10.1007/s10549-020-05863-4

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